Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | ME 72831 | FL |
NPI | 1013909860 |
---|---|
Provider Name | Peter Louis Kovacs |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32216-4207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 11/07/2017 |