Healthcare Provider Details

I. General information

NPI: 1881833382
Provider Name (Legal Business Name): FEDERICO ALFONSO AUGER D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2009
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S MOON AVE
BRANDON FL
33511-5716
US

IV. Provider business mailing address

2835 W DE LEON ST SUITE 101
TAMPA FL
33609-4130
US

V. Phone/Fax

Practice location:
  • Phone: 813-571-0123
  • Fax:
Mailing address:
  • Phone: 813-254-6592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3336
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: