Healthcare Provider Details

I. General information

NPI: 1174545149
Provider Name (Legal Business Name): FLORIDA STATE ORTHOPAEDIC SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 CAMINO GARDENS BLVD SUITE 201
BOCA RATON FL
33432-5823
US

IV. Provider business mailing address

PO BOX 14657
CLEARWATER FL
33766-4657
US

V. Phone/Fax

Practice location:
  • Phone: 772-466-0088
  • Fax:
Mailing address:
  • Phone: 727-797-6768
  • Fax: 727-797-7648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT KATZMAN
Title or Position: OWNER
Credential: M.D.
Phone: 772-466-0088