Individual
AUDREA OLIVIA VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
160 NW 170TH ST, NORTH MIAMI BEACH, FL 33169-5576
(305) 651-1100
Mailing address
807 SE 12TH CT, FORT LAUDERDALE, FL 33316-2228
(954) 825-7615
(818) 794-6742
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
67328
GA
207Q00000X
Family Medicine Physician
Primary
OS14060
FL
208M00000X
Hospitalist Physician
67328
GA
208M00000X
Hospitalist Physician
OS14060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003123893B
—
GA
05
—
GA1452
—
SC
01
—
P01202428
RAILROAD MEDICARE
GA
Enumeration date
06/22/2010
Last updated
08/29/2024
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