Healthcare Provider Details

I. General information

NPI: 1528867082
Provider Name (Legal Business Name): DAVID JAY KATZ RCSWI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7261 SHERIDAN ST STE 340
HOLLYWOOD FL
33024-2726
US

IV. Provider business mailing address

17318 BLUE WALK ST
WIMAUMA FL
33598-2541
US

V. Phone/Fax

Practice location:
  • Phone: 732-299-4977
  • Fax:
Mailing address:
  • Phone: 732-299-4977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW23610
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: