Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME104414 | FL |
N | 207VG0400X | Gynecologist | ME104414 | FL |
NPI | 1780812586 |
---|---|
Provider Name | Dr. Aimee Lynn Tieu |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32940-2239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 19/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001261800 | (05) | FL |