MEDICARE: AUGUSTINE V JOSEPH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME59230	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750360459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUGUSTINE V JOSEPH MD

Provider Business Mailing Address
First Line	:	5200 DAVISSON AVE
Second Line	:	SUITE A
City	:	ORLANDO
State	:	FL
Zip	:	32810-5350
Country	:	US
Telephone Number	:	407-290-1558
Fax Number	:	407-292-8852

Provider Business Practice Location Address
First Line	:	5200 DAVISSON AVE
Second Line	:	SUITE A
City	:	ORLANDO
State	:	FL
Zip	:	32810-5350
Country	:	US
Telephone Number	:	407-290-1558
Fax Number	:	407-292-8852

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	08/27/2014

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