Healthcare Provider Details
I. General information
NPI: 1770473217
Provider Name (Legal Business Name): KOVO CLINICS FL, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 MARKET ST # 3200B
SAN FRANCISCO CA
94105-1420
US
IV. Provider business mailing address
1 MARKET ST # 3200B
SAN FRANCISCO CA
94105-1420
US
V. Phone/Fax
- Phone: 863-400-0687
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YURY
YAKUBCHYK
Title or Position: PRESIDENT
Credential: MD
Phone: 863-400-0687