Basic Information
| Provider Information | |||||||||
| NPI: | 1376596296 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHOURI | ||||||||
| FirstName: | YOUSEF | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 S PINE ISLAND RD STE 800 | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333243923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549676400 | ||||||||
| FaxNumber: | 9549657339 | ||||||||
| Practice Location | |||||||||
| Address1: | 2939 N MILITARY TRL | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334092916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618635757 | ||||||||
| FaxNumber: | 5618636627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 03/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME57291 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 17772 | AL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 009918355 | 05 | AL | MEDICAID | 51514702KHO | 01 | AL | BCBS PROVIDER NUMBER | OTHER | 016399700 | 05 | FL | MEDICAID |