Provider Demographics
NPI:1639130131
Name:KANTOUNIS, LOUIS JOHN (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:JOHN
Last Name:KANTOUNIS
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 1:845 OAKLEY SEAVER DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1968
Mailing Address - Country:US
Mailing Address - Phone:352-432-9585
Mailing Address - Fax:352-708-4046
Practice Address - Street 1:845 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1968
Practice Address - Country:US
Practice Address - Phone:352-432-9585
Practice Address - Fax:352-708-4046
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62248207RC0000X
FL62248207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373066200Medicaid
FLME62248OtherMEDICAL LICENSE
FLME62248OtherMEDICAL LICENSE
F04662Medicare UPIN
FL15215XMedicare PIN
FL15215VMedicare PIN
FL15215WMedicare PIN