Healthcare Provider Details

I. General information

NPI: 1477581304
Provider Name (Legal Business Name): HARVEY L KATZ DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 WEST OAKLAND PARK BLVD BLDG C STE 108
SUNRISE FL
33351-1121
US

IV. Provider business mailing address

7800 WEST OAKLAND PARK BLVD BLDG C STE 108
SUNRISE FL
33351-1121
US

V. Phone/Fax

Practice location:
  • Phone: 954-742-7003
  • Fax: 954-742-7012
Mailing address:
  • Phone: 954-742-7003
  • Fax: 954-742-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4299
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN003638
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: