Healthcare Provider Details

I. General information

NPI: 1093291825
Provider Name (Legal Business Name): BEULAH DINAH AUGUSTIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEULAH DINAH CASTOR

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

PO BOX 100186
GAINESVILLE FL
32610-0186
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7283
  • Fax: 407-303-0347
Mailing address:
  • Phone: 352-265-5911
  • Fax: 352-265-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberME148516
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME148516
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: