Provider Demographics
NPI:1992218739
Name:GOVEA, KATY (MS)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:GOVEA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 SW 103RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1776
Mailing Address - Country:US
Mailing Address - Phone:786-587-7128
Mailing Address - Fax:
Practice Address - Street 1:7575 W FLAGLER ST STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2467
Practice Address - Country:US
Practice Address - Phone:305-377-3297
Practice Address - Fax:305-377-3297
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management