Provider Demographics
NPI:1104930353
Name:LURIE, SUSAN J (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:LURIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:960 ARTHUR GODFREY RD STE 312
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3348
Mailing Address - Country:US
Mailing Address - Phone:305-763-8080
Mailing Address - Fax:305-763-8064
Practice Address - Street 1:960 ARTHUR GODFREY RD STE 312
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-763-8080
Practice Address - Fax:305-763-8064
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099039207Q00000X
FLME105007207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine