Provider Demographics
NPI:1669405841
Name:OVADIA, PHILIP CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:CRAIG
Last Name:OVADIA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 37TH AVE N # 289
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1416
Mailing Address - Country:US
Mailing Address - Phone:727-472-9995
Mailing Address - Fax:727-351-8042
Practice Address - Street 1:204 37TH AVE N # 289
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-1416
Practice Address - Country:US
Practice Address - Phone:727-472-9995
Practice Address - Fax:727-351-8042
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426935208600000X, 208G00000X
FLME132749208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013165230001Medicaid
FL021753600Medicaid
I35450Medicare UPIN
PA1013165230001Medicaid