Healthcare Provider Details

I. General information

NPI: 1760489553
Provider Name (Legal Business Name): STEVEN J LOUIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5507 S CONGRESS AVE SUITE 140
ATLANTIS FL
33462-1139
US

IV. Provider business mailing address

5507 S CONGRESS AVE SUITE 140
ATLANTIS FL
33462-1139
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-6685
  • Fax: 561-965-8525
Mailing address:
  • Phone: 561-965-6685
  • Fax: 561-965-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME0039042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: