Provider Demographics
NPI:1902916265
Name:AUGUSTINE, ROBERT S (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:AUGUSTINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 BAHIA VISTA ST
Mailing Address - Street 2:#100
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239
Mailing Address - Country:US
Mailing Address - Phone:941-951-6200
Mailing Address - Fax:941-951-6300
Practice Address - Street 1:2800 BAHIA VISTA ST
Practice Address - Street 2:#100
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-951-6200
Practice Address - Fax:941-951-6300
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U12676Medicare UPIN
FL22305Medicare ID - Type Unspecified