Healthcare Provider Details

I. General information

NPI: 1891874558
Provider Name (Legal Business Name): SAWGRASS PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 GLADES RD
BOCA RATON FL
33434-3918
US

IV. Provider business mailing address

9750 NW 33RD ST SUITE 101
CORAL SPRINGS FL
33065-4042
US

V. Phone/Fax

Practice location:
  • Phone: 561-487-9912
  • Fax: 561-487-5070
Mailing address:
  • Phone: 954-752-9220
  • Fax: 954-752-1549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LORNE KATZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-752-9220