Provider Demographics
NPI:1992076426
Name:AUGUSTINE CHIROPRACTIC OFFICES
Entity type:Organization
Organization Name:AUGUSTINE CHIROPRACTIC OFFICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.C.
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:AUGUSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-951-6200
Mailing Address - Street 1:2800 BAHIA VISTA STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2710
Mailing Address - Country:US
Mailing Address - Phone:941-951-6200
Mailing Address - Fax:941-951-6300
Practice Address - Street 1:2800 BAHIA VISTA STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2710
Practice Address - Country:US
Practice Address - Phone:941-951-6200
Practice Address - Fax:941-951-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5205111N00000X
FL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty