Provider Demographics
NPI:1235323650
Name:PODIATRY ASSOCIATES OF VENICE AND ENGLEWOOD
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES OF VENICE AND ENGLEWOOD
Other - Org Name:GULF COAST FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:941-484-2602
Mailing Address - Street 1:400 TAMIAMI TRL S STE 200
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2624
Mailing Address - Country:US
Mailing Address - Phone:941-484-2602
Mailing Address - Fax:941-484-3748
Practice Address - Street 1:400 TAMIAMI TRL S STE 200
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2624
Practice Address - Country:US
Practice Address - Phone:941-484-2602
Practice Address - Fax:941-484-3748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCA2534OtherRAIL ROAD MEDICARE
FL1154390001Medicare NSC
FLT88548Medicare UPIN
FL33479Medicare PIN