Provider Demographics
NPI:1912936469
Name:AUGEREAU, J PAUL H (MD)
Entity Type:Individual
Prefix:DR
First Name:J PAUL
Middle Name:H
Last Name:AUGEREAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:AUGEREAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:770 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-2837
Mailing Address - Country:US
Mailing Address - Phone:727-943-9339
Mailing Address - Fax:
Practice Address - Street 1:9330 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1808
Practice Address - Country:US
Practice Address - Phone:727-834-4000
Practice Address - Fax:727-834-4912
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46833207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912936469OtherNPI
FL273487700Medicaid
FLME0046833OtherSTATE LICENSING