Provider Demographics
NPI:1144223363
Name:KATZ, MARC A (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:KATZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 272284
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33688-2284
Mailing Address - Country:US
Mailing Address - Phone:813-875-0555
Mailing Address - Fax:866-313-3106
Practice Address - Street 1:2919 W SWANN AVE
Practice Address - Street 2:STE 203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4038
Practice Address - Country:US
Practice Address - Phone:813-875-0555
Practice Address - Fax:866-313-3106
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2532213ES0103X, 213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDA5546OtherRR GROUP
FL003TGOtherBCBS GROUP
FL390343500Medicaid
FL608135000OtherDEPT OF LABOR
FLPO2532OtherMED LIC
FL2781096OtherEVERCARE
FLP00063086OtherRR INDIVIDUAL
FL01028OtherUNIVERSAL
FL6202514OtherGHI
FL65499OtherBCBS
FL65499OtherBCBS
FL390343500Medicaid
FL390343500Medicaid
FLDA5546OtherRR GROUP
FL2781096OtherEVERCARE
FL6202514OtherGHI