1184678633 NPI number — KATZ CASEY LEVINE MD PA

Table of content: (NPI 1184678633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184678633 NPI number — KATZ CASEY LEVINE MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KATZ CASEY LEVINE MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184678633
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 N FEDERAL HWY
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
FT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33308-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-621-3897
Provider Business Mailing Address Fax Number:
305-675-2788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5700 N FEDERAL HWY
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
FT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33308-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-621-3897
Provider Business Practice Location Address Fax Number:
305-675-2788
Provider Enumeration Date:
05/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KATZ
Authorized Official First Name:
ARMAND
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
786-621-3897

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  ME24070 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 020020909 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 020308 . This is a "NHP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 93011 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 375478200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".