Provider Demographics
NPI:1427035120
Name:KATZ, BARRY RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:RICHARD
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 1:623 MAITLAND AVENUE
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701
Mailing Address - Country:US
Mailing Address - Phone:407-830-8661
Mailing Address - Fax:407-830-0280
Practice Address - Street 1:623 MAITLAND AVENUE
Practice Address - Street 2:SUITE 2200
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-830-8661
Practice Address - Fax:407-830-0280
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57670207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10416Medicare ID - Type Unspecified
E61636Medicare UPIN