Provider Demographics
NPI:1760444343
Name:KATZ, GARY E (DPM)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:E
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 1:6600 34TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1515
Mailing Address - Country:US
Mailing Address - Phone:727-343-2244
Mailing Address - Fax:727-347-0777
Practice Address - Street 1:6600 34TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1515
Practice Address - Country:US
Practice Address - Phone:727-343-2244
Practice Address - Fax:727-347-0777
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-2706213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU67687Medicare UPIN
FL65552Medicare ID - Type Unspecified