Provider Demographics
NPI:1700835378
Name:DRS. KOVACS & RESNICK, PA
Entity Type:Organization
Organization Name:DRS. KOVACS & RESNICK, PA
Other - Org Name:OLD NAME - DR. ANDREW G KOVACS MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-865-1995
Mailing Address - Street 1:1111 KANE CONCOURSE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2029
Mailing Address - Country:US
Mailing Address - Phone:305-865-1995
Mailing Address - Fax:305-866-1844
Practice Address - Street 1:1111 KANE CONCOURSE
Practice Address - Street 2:SUITE 504
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2029
Practice Address - Country:US
Practice Address - Phone:305-865-1995
Practice Address - Fax:305-866-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 416882084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6665Medicare PIN
FL96180AMedicare PIN
FL93679AMedicare PIN