Healthcare Provider Details

I. General information

NPI: 1376505362
Provider Name (Legal Business Name): TODD A. KOVACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 VIRGINIA ST STE 200
DUNEDIN FL
34698-6612
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 727-724-8611
  • Fax: 727-724-0425
Mailing address:
  • Phone: 727-532-0002
  • Fax: 813-635-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME72467
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: