Provider Demographics
NPI:1497955850
Name:KOVACS, LORI KAY (SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:KAY
Last Name:KOVACS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 SPRING VILLAS PT
Mailing Address - Street 2:STE. 1030
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5258
Mailing Address - Country:US
Mailing Address - Phone:407-629-9455
Mailing Address - Fax:407-629-9138
Practice Address - Street 1:2025 SW 75TH ST STE 30
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-3467
Practice Address - Country:US
Practice Address - Phone:352-333-1195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5261235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA5261OtherSPEECH LICENSE