Provider Demographics
NPI:1912210469
Name:SCHMIDT, AUGUSTO FREDERICO SANTOS (MD PHD)
Entity Type:Individual
Prefix:
First Name:AUGUSTO
Middle Name:FREDERICO SANTOS
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:AUGUSTO
Other - Middle Name:FREDERICO
Other - Last Name:SANTOS SCHMIDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1611 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-243-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1214372080N0001X, 208000000X
FLME1341102080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics