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NPI Code Detail

MEDICARE: MR. BRIAN J AUGUSTINE DC, DACNB

MEDICARE:  MR. BRIAN J AUGUSTINE  DC, DACNB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NN0400XNeurology ChiropractorCH0006174FL

General Provider Information

NPI Number : 1508935099
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN J AUGUSTINE DC, DACNB
Provider Business Mailing Address
First Line : 5317 VILLAGE MARKET
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33543-4251
Country : US
Telephone Number : 813-994-6008
Fax Number : 813-994-3063
Provider Business Practice Location Address
First Line : 5317 VILLAGE MARKET
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33543-4251
Country : US
Telephone Number : 813-994-6008
Fax Number : 813-994-3063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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