Individual
JOHN KENNETH LOURIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4900 MANATEE AVE. W, SUITE 201, BRADENTON, FL 34209
(941) 746-5200
(941) 746-5266
Mailing address
4900 MANATEE AVE. W, SUITE 201, BRADENTON, FL 34209
(941) 746-5200
(941) 746-5266
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
ME0068394
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205060385
TAX ID
FL
01
—
27143
BCBS OF FL
FL
05
—
378088100
—
FL
Enumeration date
08/18/2005
Last updated
05/06/2013
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