Provider Demographics
NPI:1750509519
Name:LUIS A JOVEL MD PA
Entity Type:Organization
Organization Name:LUIS A JOVEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:727-327-5188
Mailing Address - Street 1:2323 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8818
Mailing Address - Country:US
Mailing Address - Phone:727-327-5188
Mailing Address - Fax:727-321-3728
Practice Address - Street 1:2323 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8818
Practice Address - Country:US
Practice Address - Phone:727-327-5188
Practice Address - Fax:727-321-3728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC779Medicare PIN