MEDICARE: SHMUEL ERNO KATZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME 0038847	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578636452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHMUEL ERNO KATZ MD

Provider Business Mailing Address
First Line	:	10185 COLLINS AVE
Second Line	:	SUITE 418
City	:	BAL HARBOUR
State	:	FL
Zip	:	33154-1600
Country	:	US
Telephone Number	:	305-864-7770
Fax Number	:	305-864-7272

Provider Business Practice Location Address
First Line	:	100 NW 170TH ST
Second Line	:	WOUND CARE CLINIC SUITE 105
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33169-5513
Country	:	US
Telephone Number	:	305-654-5069
Fax Number	:	305-654-5217

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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