Healthcare Provider Details

I. General information

NPI: 1104165539
Provider Name (Legal Business Name): GRETCHEN HIRPHA AUGUSTIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 NW 12TH AVE SUITE 200
MIAMI FL
33136-1002
US

IV. Provider business mailing address

1475 NW 12TH AVE STE 200
MIAMI FL
33136-1002
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-7055
  • Fax: 305-243-5210
Mailing address:
  • Phone: 305-243-7055
  • Fax: 305-243-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9206233
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN9206233
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: