Provider Demographics
NPI:1538286810
Name:KATZ, JONATHAN CRAIG (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CRAIG
Last Name:KATZ
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4198 SABAL RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-5040
Mailing Address - Country:US
Mailing Address - Phone:954-270-4915
Mailing Address - Fax:954-385-3271
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:C-300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-8342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89604207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology