Provider Demographics
NPI:1407250434
Name:AUGUSTIN, BERLINE (RPH)
Entity Type:Individual
Prefix:
First Name:BERLINE
Middle Name:
Last Name:AUGUSTIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:BERLINE
Other - Middle Name:
Other - Last Name:BARONVIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:13440 NW 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-6612
Mailing Address - Country:US
Mailing Address - Phone:786-558-6188
Mailing Address - Fax:
Practice Address - Street 1:13440 NW 11TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-6612
Practice Address - Country:US
Practice Address - Phone:786-558-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist