Provider Demographics
NPI:1568404663
Name:LIU, AUDREY (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 LINTON BLVD STE F107
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6506
Mailing Address - Country:US
Mailing Address - Phone:561-455-1337
Mailing Address - Fax:561-498-3579
Practice Address - Street 1:4800 LINTON BLVD STE F107
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6506
Practice Address - Country:US
Practice Address - Phone:561-498-5660
Practice Address - Fax:561-498-0753
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT043985207R00000X
FLME116636207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine