Healthcare Provider Details

I. General information

NPI: 1801875117
Provider Name (Legal Business Name): LUIS E AUGSTEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11400 OVERSEAS HIGHWAY SUITE 106-108
MARATHON FL
33050-3600
US

IV. Provider business mailing address

PO BOX 522709
MARATHON SHORES FL
33052-2709
US

V. Phone/Fax

Practice location:
  • Phone: 305-320-2451
  • Fax:
Mailing address:
  • Phone: 305-320-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME36151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: