Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME13348 | FL |
Y | 208600000X | Surgeon | ME13348 | FL |
NPI | 1003955113 |
---|---|
Provider Name | Gabor Kovacs |
First Address | Fernandina Beach, FL 32034-1979 |
Second Address | Fernandina Beach, FL 32034-1979 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 30/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D18419 | (02) | NJ |