Organization
ADVANCED CARDIOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KENNETH LOURIE MD (OWNER)
(941) 773-0244
Entity
Organization
Contact information
Practice address
4900 MANATEE AVE W, SUITE 201, BRADENTON, FL 34209-3859
(941) 746-5200
(941) 746-5266
Mailing address
4900 MANATEE AVE W, SUITE 201, BRADENTON, FL 34209-3859
(941) 746-5200
(941) 746-5266
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF6445
RR MEDICARE
FL
Enumeration date
10/11/2006
Last updated
06/21/2018
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