Individual
DR. BRADLEY TODD KOVACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 ANCHOR RODE DR STE 100, NAPLES, FL 34103-2742
(239) 263-1717
(239) 403-9410
Mailing address
801 ANCHOR RODE DR STE 100, NAPLES, FL 34103-2742
(239) 263-1717
(239) 403-9410
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2006012910
MO
207N00000X
Dermatology Physician
Primary
ME98276
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME98276
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208189
MO-BLUE SHIELD
—
Enumeration date
07/25/2006
Last updated
10/06/2020
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