=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467676429
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADAM J KATZ DPM PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2007
-----------------------------------------------------
Last Update Date | 01/11/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6080 W BOYNTON BEACH BLVD STE 100
-----------------------------------------------------
City | BOYNTON BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33437-3586
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-364-9584
-----------------------------------------------------
Fax | 561-364-9645
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8200 JOG RD SUITE 205
-----------------------------------------------------
City | BOYNTON BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33472-2981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-364-9584
-----------------------------------------------------
Fax | 561-364-9645
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ADAM J. KATZ
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 561-364-9584
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | PO2863
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------