=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669405841
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PHILIP CRAIG OVADIA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2006
-----------------------------------------------------
Last Update Date | 06/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 37TH AVE N # 289
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33704-1416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-472-9995
-----------------------------------------------------
Fax | 727-351-8042
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 37TH AVE N # 289
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33704-1416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-480-6639
-----------------------------------------------------
Fax | 727-351-8042
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208G00000X
-----------------------------------------------------
Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
-----------------------------------------------------
License Number | ME132749
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | MD426935
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208G00000X
-----------------------------------------------------
Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
-----------------------------------------------------
License Number | MD426935
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------