Provider Demographics
NPI:1639236359
Name:KATZ, ADAM J (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:J
Last Name:KATZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:8200 JOG RD
Practice Address - Street 2:SUITE 205
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-2981
Practice Address - Country:US
Practice Address - Phone:561-364-9584
Practice Address - Fax:561-364-9645
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2863213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U83101Medicare UPIN
FLK6615Medicare ID - Type UnspecifiedMEDICARE