Provider Demographics
NPI:1366468795
Name:AURELIEN, PATRICIA JUDE (DO)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:JUDE
Last Name:AURELIEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N FLAGLER AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-6635
Mailing Address - Country:US
Mailing Address - Phone:954-786-0691
Mailing Address - Fax:
Practice Address - Street 1:114 N FLAGLER AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6635
Practice Address - Country:US
Practice Address - Phone:954-786-0691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276962000Medicaid
FLAE976WMedicare PIN