Healthcare Provider Details

I. General information

NPI: 1912210469
Provider Name (Legal Business Name): AUGUSTO FREDERICO SANTOS SCHMIDT M.D. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AUGUSTO FREDERICO SANTOS SCHMIDT

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136
US

IV. Provider business mailing address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-3933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.121437
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.121437
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME134110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: