Provider Demographics
NPI:1437542909
Name:ANDREW S MARKOVITS
Entity Type:Organization
Organization Name:ANDREW S MARKOVITS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:COA
Authorized Official - Phone:850-457-3753
Mailing Address - Street 1:905 N NAVY BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-1274
Mailing Address - Country:US
Mailing Address - Phone:850-457-3753
Mailing Address - Fax:850-457-0200
Practice Address - Street 1:905 N NAVY BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-1274
Practice Address - Country:US
Practice Address - Phone:850-457-3753
Practice Address - Fax:850-457-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0039494305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067315300Medicaid
FL1376693481OtherNPI
FLD53324Medicare UPIN