Healthcare Provider Details

I. General information

NPI: 1538286810
Provider Name (Legal Business Name): JONATHAN CRAIG KATZ M.D., D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE C-300
MIAMI FL
33136-1005
US

IV. Provider business mailing address

4198 SABAL RIDGE CIR
WESTON FL
33331-5040
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-8342
  • Fax:
Mailing address:
  • Phone: 954-270-4915
  • Fax: 954-385-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number73562
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME89604
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: