MEDICARE: DR. CHRISTIAN A KOVATS DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OP00001040	WA
2	207Q00000X	Family Medicine Physician	OS0005530	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063400117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN A KOVATS DO

Provider Business Mailing Address
First Line	:	3821 WOODBRIAR TRL STE 6
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-9611
Country	:	US
Telephone Number	:	386-333-6158
Fax Number	:	386-333-6158

Provider Business Practice Location Address
First Line	:	3821 WOODBRIAR TRL STE 6
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-9611
Country	:	US
Telephone Number	:	845-996-8177
Fax Number	:	718-362-1651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	03/27/2026

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