Provider Demographics
NPI:1023135142
Name:JEFFREY L KATZELL MD PA
Entity type:Organization
Organization Name:JEFFREY L KATZELL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:KATZELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-642-1219
Mailing Address - Street 1:7408 LAKE WORTH RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2531
Mailing Address - Country:US
Mailing Address - Phone:561-642-1219
Mailing Address - Fax:561-642-6568
Practice Address - Street 1:7408 LAKE WORTH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2531
Practice Address - Country:US
Practice Address - Phone:561-642-1219
Practice Address - Fax:561-642-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0050379174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty