Provider Demographics
NPI:1588336689
Name:AUGUSTINO, OLIVIA (DC)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:AUGUSTINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S WINTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5457
Mailing Address - Country:US
Mailing Address - Phone:407-951-7591
Mailing Address - Fax:
Practice Address - Street 1:950 S WINTER PARK DR
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5457
Practice Address - Country:US
Practice Address - Phone:407-951-7591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor