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General NPI Number Information
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NPI Number | 1184680381
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Entity Type | Individual
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Provider Name | CHARLES ANDERSON AUGUSTUS MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 950 N KROME AVE STE 403
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City | HOMESTEAD
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State | FL
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Zip | 33030-4443
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Country | US
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Telephone | 305-245-1611
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Fax | 305-245-8898
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Provider Business Mailing Address
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Address Line | 950 N KROME AVE STE 403
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City | HOMESTEAD
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State | FL
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Zip | 33030-4443
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Country | US
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Telephone | 305-245-1611
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Fax | 305-245-8898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME 42610
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License Number State | FL
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