Provider Demographics
NPI:1063400117
Name:KOVATS, CHRISTIAN A (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:A
Last Name:KOVATS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3821 WOODBRIAR TRL STE 6
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-9611
Mailing Address - Country:US
Mailing Address - Phone:863-333-6158
Mailing Address - Fax:386-333-6158
Practice Address - Street 1:3821 WOODBRIAR TRL STE 6
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-9611
Practice Address - Country:US
Practice Address - Phone:863-333-6158
Practice Address - Fax:386-333-6158
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001040207Q00000X
FLOS0005530207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1063400117Medicaid
WAG8942100, G8942099Medicare PIN
FL80466OtherBCBS
FL593498878OtherCIGNA
80466SMedicare PIN
FLF00138Medicare UPIN
FL104275OtherAVMED
FL80466VMedicare PIN