MEDICARE: ANOOP AUGUSTIN PT

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	225100000X	Physical Therapist	PT23772	FL

General Provider Information

NPI Number	:	1972874337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANOOP AUGUSTIN PT

Provider Business Mailing Address
First Line	:	3803 SW 165TH AVE
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4642
Country	:	US
Telephone Number	:	954-661-3923
Fax Number	:

Provider Business Practice Location Address
First Line	:	7751 W BROWARD BLVD
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-2003
Country	:	US
Telephone Number	:	954-473-8040
Fax Number	:

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

Provider Enumeration Date	:	01/17/2012
Last Update Date	:	01/17/2012

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Directions to “ ANOOP AUGUSTIN PT” Practice Location

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