Healthcare Provider Details
I. General information
NPI: 1861329054
Provider Name (Legal Business Name): PREMIER CHIROPRACTIC & WELLNESS ST. AUGUSTINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5900 US 1 S # 302
SAINT AUGUSTINE FL
32086-8824
US
IV. Provider business mailing address
5900 US 1 S # 302
SAINT AUGUSTINE FL
32086-8824
US
V. Phone/Fax
- Phone: 386-585-4441
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERIKA
EQUIZI
Title or Position: OWNER
Credential: DC
Phone: 352-871-1962