Provider Demographics
NPI:1699761098
Name:KATT, LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:KATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 S WASHINGTON AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-5800
Mailing Address - Country:US
Mailing Address - Phone:321-225-8004
Mailing Address - Fax:321-225-4326
Practice Address - Street 1:3910 S WASHINGTON AVE STE 207
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-5800
Practice Address - Country:US
Practice Address - Phone:321-225-8004
Practice Address - Fax:321-225-4326
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51241207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049939199Medicaid
FL08321OtherBCBS
FL08321OtherBCBS
E15492Medicare UPIN
FLP00443854Medicare PIN
FL08321RMedicare PIN