Provider Demographics
NPI:1376782631
Name:AIDEN O'ROURKE MD PA
Entity Type:Organization
Organization Name:AIDEN O'ROURKE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AIDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'ROURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-525-7350
Mailing Address - Street 1:1625 SE 3RD AVE
Mailing Address - Street 2:SUITE 723
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2521
Mailing Address - Country:US
Mailing Address - Phone:954-525-7350
Mailing Address - Fax:954-525-0808
Practice Address - Street 1:1625 SE 3RD AVE
Practice Address - Street 2:SUITE 723
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-525-7350
Practice Address - Fax:954-525-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44786208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty