MEDICARE: CHARLES A. AUGUSTUS II, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME 42610	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12156	OTHER	FL	BCBS OF FLORIDA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740576305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLES A. AUGUSTUS II, M.D., P.A.

Provider Business Mailing Address
First Line	:	950 N KROME AVE STE 403
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-4443
Country	:	US
Telephone Number	:	305-245-1611
Fax Number	:	305-245-8898

Provider Business Practice Location Address
First Line	:	950 N KROME AVE STE 403
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-4443
Country	:	US
Telephone Number	:	305-245-1611
Fax Number	:	305-245-8898

Authorized Official
Title or Position	:	CLERK
Name	:	MRS. DEBBIE RUFIN
Credential	:
Telephone Number	:	305-245-1611

Provider Enumeration Date	:	06/22/2011
Last Update Date	:	04/17/2012

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