Healthcare Provider Details

I. General information

NPI: 1477559458
Provider Name (Legal Business Name): AUGUSTIN JOSEPH SCHWARTZ III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 N FLAGLER DR FLORIDA CANCER SPECIALISTS PL
WEST PALM BEACH FL
33401-3406
US

IV. Provider business mailing address

4371 VERONICA S SHOEMAKER BLVD ATTN CREDENTIALING
FORT MYERS FL
33916-2216
US

V. Phone/Fax

Practice location:
  • Phone: 561-366-4100
  • Fax: 561-366-4189
Mailing address:
  • Phone: 239-274-8200
  • Fax: 239-278-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME25468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: