Provider Demographics
NPI:1376505362
Name:KOVACH, TODD A (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:A
Last Name:KOVACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:455 PINELLAS ST STE 330
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3369
Mailing Address - Country:US
Mailing Address - Phone:727-724-8611
Mailing Address - Fax:727-724-0425
Practice Address - Street 1:455 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3367
Practice Address - Country:US
Practice Address - Phone:727-724-8611
Practice Address - Fax:727-724-0425
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72467207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253366900Medicaid
FLF31613Medicare UPIN
FL253366900Medicaid
FL32897SMedicare PIN
FL32897YMedicare PIN