Provider Demographics
NPI:1710448659
Name:AIELLO, MICHAEL ROCCO (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ROCCO
Last Name:AIELLO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N UNIVERSITY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6071
Mailing Address - Country:US
Mailing Address - Phone:954-458-1199
Mailing Address - Fax:
Practice Address - Street 1:7050 NW 4TH ST STE 206
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2247
Practice Address - Country:US
Practice Address - Phone:954-458-1199
Practice Address - Fax:877-207-4010
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS20010208VP0014X, 208VP0014X
FLUO6788208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program