Provider Demographics
NPI:1467676429
Name:ADAM J KATZ DPM PA
Entity Type:Organization
Organization Name:ADAM J KATZ DPM PA
Other - Org Name:PREMIER PODIATRY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-364-9584
Mailing Address - Street 1:8200 JOG RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2981
Mailing Address - Country:US
Mailing Address - Phone:561-364-9584
Mailing Address - Fax:561-364-9645
Practice Address - Street 1:6080 W BOYNTON BEACH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3586
Practice Address - Country:US
Practice Address - Phone:561-364-9584
Practice Address - Fax:561-364-9645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2863213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6615Medicare ID - Type UnspecifiedMEDICARE
FL5490420001Medicare NSC