Healthcare Provider Details

I. General information

NPI: 1821055963
Provider Name (Legal Business Name): ALEXANDER LURIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 W 41ST ST STE 200
MIAMI BEACH FL
33140-3304
US

IV. Provider business mailing address

825 W 41ST ST STE 200
MIAMI BEACH FL
33140-3304
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-4840
  • Fax: 305-456-4897
Mailing address:
  • Phone: 305-456-4840
  • Fax: 305-456-4897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number036-101490
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME 105168
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: