# K JEAN JOVIAK MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205036555
- **Authorized official:** DR. KARLA JEAN JOVIAK MD (PRESIDENT/MD)
- **Authorized official phone:** (352) 239-4659

## Contact information

- **Practice address:** 860 S VILLAGE DR N, 105, ST PETERSBURG, FL 33716-3024
- **Practice address phone:** (352) 239-4659
- **Practice address fax:** (352) 237-4055
- **Mailing address:** PO BOX 770584, OCALA, FL 34477-0584
- **Mailing address phone:** (352) 239-4659
- **Mailing address fax:** (352) 237-4055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2007
- **Last updated:** 05/06/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0105204 | UNITED | FL |
| 05 | — | 045854600 | — | FL |
| 01 | — | 080108978 | RAILROAD MEDICARE | FL |
| 01 | — | 1792714 | CIGNA | FL |
| 01 | — | 62326 | BLUE CROSS BLUE SHIELD | FL |
| 01 | — | 961280 | AETNA | FL |