Healthcare Provider Details

I. General information

NPI: 1922573161
Provider Name (Legal Business Name): FAMILY FOCUS CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 KENT RD STE 1A
ST AUGUSTINE FL
32086-6485
US

IV. Provider business mailing address

150 KENT RD STE 1A
ST AUGUSTINE FL
32086-6485
US

V. Phone/Fax

Practice location:
  • Phone: 904-999-7873
  • Fax: 904-342-0009
Mailing address:
  • Phone: 904-999-7873
  • Fax: 904-342-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINE M PASCUAL
Title or Position: DOCTOR/OWNER
Credential: DC
Phone: 904-999-7873