MEDICARE: LOUIS JOHN KANTOUNIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME62248	FL
2	207RI0011X	Interventional Cardiology Physician	62248	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME62248	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1639130131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS JOHN KANTOUNIS MD

Provider Business Mailing Address
First Line	:	845 OAKLEY SEAVER DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1968
Country	:	US
Telephone Number	:	352-432-9585
Fax Number	:	352-708-4046

Provider Business Practice Location Address
First Line	:	845 OAKLEY SEAVER DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1968
Country	:	US
Telephone Number	:	352-432-9585
Fax Number	:	352-708-4046

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2006
Last Update Date	:	03/27/2020

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