Provider Demographics
NPI:1508935099
Name:AUGUSTINE, BRIAN J (DC, DACNB)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:AUGUSTINE
Suffix:
Gender:M
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 VILLAGE MARKET
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4251
Mailing Address - Country:US
Mailing Address - Phone:813-994-6008
Mailing Address - Fax:813-994-3063
Practice Address - Street 1:5317 VILLAGE MARKET
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-4251
Practice Address - Country:US
Practice Address - Phone:813-994-6008
Practice Address - Fax:813-994-3063
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006174111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT95652Medicare UPIN
FL89273ZMedicare ID - Type Unspecified