Provider Demographics
NPI:1437262466
Name:LURIE, MARC A (OD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:LURIE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10047 SUNSET STRIP
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5303
Mailing Address - Country:US
Mailing Address - Phone:954-572-8524
Mailing Address - Fax:954-572-8923
Practice Address - Street 1:10047 SUNSET STRIP
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-5303
Practice Address - Country:US
Practice Address - Phone:954-572-8524
Practice Address - Fax:954-572-8923
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1237152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL084934100Medicaid
FLT84075Medicare UPIN
FL19307Medicare ID - Type Unspecified