Provider Demographics
NPI:1447480793
Name:KATZ ORTHOPAEDIC INSTITUTE, LLC
Entity type:Organization
Organization Name:KATZ ORTHOPAEDIC INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-869-2663
Mailing Address - Street 1:PO BOX 919295
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9295
Mailing Address - Country:US
Mailing Address - Phone:727-869-2663
Mailing Address - Fax:
Practice Address - Street 1:14153 YOSEMITE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-8060
Practice Address - Country:US
Practice Address - Phone:727-869-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064682207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373528100Medicaid
1104854058OtherINDIVIDUAL NPI
FLF51501Medicare UPIN
FL23239YMedicare PIN
FL200015939Medicare PIN