Provider Demographics
NPI:1689934069
Name:SUSAN LURIE MD PA
Entity Type:Organization
Organization Name:SUSAN LURIE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-763-8080
Mailing Address - Street 1:825 ARTHUR GODFREY RD FL 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3304
Mailing Address - Country:US
Mailing Address - Phone:305-763-8080
Mailing Address - Fax:305-763-8064
Practice Address - Street 1:825 ARTHUR GODFREY RD FL 2
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3304
Practice Address - Country:US
Practice Address - Phone:305-763-8080
Practice Address - Fax:305-763-8064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty