Provider Demographics
NPI:1285729871
Name:OLIVEIRA, AGOSTINHO M (DC)
Entity type:Individual
Prefix:DR
First Name:AGOSTINHO
Middle Name:M
Last Name:OLIVEIRA
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:163 HAMPTON POINT DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3059
Mailing Address - Country:US
Mailing Address - Phone:904-230-2717
Mailing Address - Fax:904-230-2720
Practice Address - Street 1:163 HAMPTON POINT DR
Practice Address - Street 2:SUITE 4
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-3059
Practice Address - Country:US
Practice Address - Phone:904-230-2717
Practice Address - Fax:904-230-2720
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLCH9245111N00000X
NYX008831-1111N00000X
VA0104555764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor