Provider Demographics
NPI:1801875117
Name:AUGSTEN, LUIS E (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:E
Last Name:AUGSTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 522709
Mailing Address - Street 2:
Mailing Address - City:MARATHON SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33052-2709
Mailing Address - Country:US
Mailing Address - Phone:305-320-2451
Mailing Address - Fax:
Practice Address - Street 1:11400 OVERSEAS HIGHWAY
Practice Address - Street 2:SUITE 106-108
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3600
Practice Address - Country:US
Practice Address - Phone:305-320-2451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36151207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96273OtherBC BS FL
FLP00455534OtherRAILROAD MEDICARE
FLD63801Medicare UPIN
FLP00455534OtherRAILROAD MEDICARE