Basic Information
| Provider Information | |||||||||
| NPI: | 1063808400 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AUGUSTE | ||||||||
| FirstName: | MILHENKA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7808 NW 61ST TER | ||||||||
| Address2: | |||||||||
| City: | PARKLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330675107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546751455 | ||||||||
| FaxNumber: | 5618375190 | ||||||||
| Practice Location | |||||||||
| Address1: | 39200 HOOKER HWY | ||||||||
| Address2: | |||||||||
| City: | BELLE GLADE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334305368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619966571 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2015 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 13675 I | PR | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | 19126 | PR | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | ACN731 | FL | N | Allopathic & Osteopathic Physicians | General Practice | 390200000X | TRN32437 | FL | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
ID Information
| ID | Type | State | Issuer | Description | 019444700 | 05 | FL | MEDICAID |