| Indian River Medical Center LLC | |
|
3821 Woodbriar Trl Ste 6 Port Orange FL 32129-9611 | |
| (386) 333-6158 | |
| (386) 333-6158 |
| Full Name | Indian River Medical Center LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 3821 Woodbriar Trl Ste 6, Port Orange, Florida |
| Authorized Official Name and Position | Christian Andrew Kovats (OWNER) |
| Authorized Official Contact | 2089200932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian River Medical Center LLC 3821 Woodbriar Trl Ste 106 Port Orange FL 32129-9615 Ph: (386) 333-6158 | Indian River Medical Center LLC 3821 Woodbriar Trl Ste 6 Port Orange FL 32129-9611 Ph: (386) 333-6158 |
| NPI Number | 1841010816 |
|---|---|
| Provider Enumeration Date | 10/15/2024 |
| Last Update Date | 08/13/2026 |
| Certification Date | 08/13/2026 |
| Medicare PECOS PAC ID | 7315461449 |
|---|---|
| Medicare Enrollment ID | O20250409003678 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841010816 | NPI | - | NPPES |
| 1376042134 | Other | FL | APRN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Christian Ap Kovats |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063400117 PECOS PAC ID: 0345255097 Enrollment ID: I20100602000397 |
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