Provider Demographics
NPI:1770052334
Name:KATALYST HEALTH, LLC
Entity type:Organization
Organization Name:KATALYST HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-699-7696
Mailing Address - Street 1:14704 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6194
Mailing Address - Country:US
Mailing Address - Phone:954-699-7696
Mailing Address - Fax:954-206-6346
Practice Address - Street 1:14704 SW 11 STREET
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027
Practice Address - Country:US
Practice Address - Phone:954-699-7696
Practice Address - Fax:954-206-6346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty