Provider Demographics
NPI:1407226475
Name:AUGUSTIN, PETIT LOUIS (ARNP)
Entity Type:Individual
Prefix:MR
First Name:PETIT LOUIS
Middle Name:
Last Name:AUGUSTIN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 NW 123RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-2322
Mailing Address - Country:US
Mailing Address - Phone:305-890-7974
Mailing Address - Fax:
Practice Address - Street 1:1410 NW 123RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-2322
Practice Address - Country:US
Practice Address - Phone:305-890-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9357459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily