Healthcare Provider Details

I. General information

NPI: 1912936469
Provider Name (Legal Business Name): J PAUL H. AUGEREAU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN AUGEREAU MD

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STATE ROAD 54
TRINITY FL
34655-1808
US

IV. Provider business mailing address

770 S FLORIDA AVE
TARPON SPRINGS FL
34689-2837
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4000
  • Fax: 727-834-4912
Mailing address:
  • Phone: 727-943-9339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME46833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: