MEDICARE: YAMIL H KOURI M.D.

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	207RH0003X	Hematology & Oncology Physician	ME158230	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0112518	OTHER	MA	AETNA US HEALTH
2	075855	OTHER	MA	TUFTS HEALTH CARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	J12474	OTHER	MA	BLUE CROSS BLUE SHIELD
5	B20156401	OTHER	MA	CIGNA
6	14333	OTHER	MA	HARVARD PILGRIM

General Provider Information

NPI Number	:	1770566945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMIL H KOURI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 25487
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34277-2487
Country	:	US
Telephone Number	:	941-202-5342
Fax Number	:	617-479-3500

Provider Business Practice Location Address
First Line	:	6600 UNIVERSITY PKWY STE 204
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-9041
Country	:	US
Telephone Number	:	941-923-1872
Fax Number	:	941-923-3947

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	11/22/2023

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Directions to “ YAMIL H KOURI M.D.” Practice Location

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