=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942395454
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AGUSTIN M FLORIAN, MD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 01/06/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 825 WASHINGTON ST SUITE # 115
-----------------------------------------------------
City | NORWOOD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02062-3441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-769-2503
-----------------------------------------------------
Fax | 781-769-4696
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 825 WASHINGTON ST SUITE # 115
-----------------------------------------------------
City | NORWOOD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02062-3441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-769-2503
-----------------------------------------------------
Fax | 781-769-4696
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | AGUSTIN M FLORIAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 781-769-2503
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208G00000X
-----------------------------------------------------
Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------