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General NPI Number Information
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NPI Number | 1205626264
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Entity Type | Individual
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Provider Name | ERNST AUGUSTIN
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Gender | Male
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 22655 BAYSHORE RD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33980-2018
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Country | US
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Telephone | 941-451-9743
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Fax | 239-310-2045
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Provider Business Mailing Address
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Address Line | 218 NW 13TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33993-1110
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Country | US
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Telephone | 307-340-2713
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-380223
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License Number State | FL
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