Provider Demographics
NPI:1679078117
Name:KOVALSKIY, ALEKSANDR (MD)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDR
Middle Name:
Last Name:KOVALSKIY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ALEKS
Other - Middle Name:
Other - Last Name:KOVALSKIY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:400 N TAMPA ST FL 15
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4730
Mailing Address - Country:US
Mailing Address - Phone:888-803-3370
Mailing Address - Fax:888-803-3331
Practice Address - Street 1:400 N TAMPA ST FL 15
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4730
Practice Address - Country:US
Practice Address - Phone:888-803-3370
Practice Address - Fax:888-803-3331
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA173918207Q00000X
NC2019-02207207Q00000X
NY323047207Q00000X
FLME162561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine