Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME78816 | FL |
NPI | 1215043203 |
---|---|
Provider Name | Dr. Endre Kovacs |
First Address | Niceville, FL 32578-9724 |
Second Address | Niceville, FL 32578-9724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 01/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G43429 | (02) |