Provider Demographics
NPI:1164453981
Name:KATZ, ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 NW PEACOCK BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2349
Mailing Address - Country:US
Mailing Address - Phone:772-446-4230
Mailing Address - Fax:772-446-4758
Practice Address - Street 1:260 NW PEACOCK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2349
Practice Address - Country:US
Practice Address - Phone:772-446-4230
Practice Address - Fax:772-446-4758
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95696207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
U7868YOtherMEDICARE RETIRED RAILROAD
FLU7868OtherBCBS OF FLORIDA
FL277043100Medicaid
U7868ZOtherMEDICARE RETIRED RAILROAD
U7868ZOtherMEDICARE RETIRED RAILROAD
FLU7868OtherBCBS OF FLORIDA
FL277043100Medicaid