Provider Demographics
NPI:1770566945
Name:KOURI, YAMIL H (MD)
Entity type:Individual
Prefix:
First Name:YAMIL
Middle Name:H
Last Name:KOURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 25487
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2487
Mailing Address - Country:US
Mailing Address - Phone:941-202-5342
Mailing Address - Fax:617-479-3500
Practice Address - Street 1:6600 UNIVERSITY PKWY STE 204
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-9041
Practice Address - Country:US
Practice Address - Phone:941-923-1872
Practice Address - Fax:941-923-3947
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME158230207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0112518OtherAETNA US HEALTH
MA075855OtherTUFTS HEALTH CARE
MA3095967Medicaid
MAJ12474OtherBLUE CROSS BLUE SHIELD
MAB20156401OtherCIGNA
MA14333OtherHARVARD PILGRIM
MA0112518OtherAETNA US HEALTH
MAJ12474Medicare ID - Type Unspecified