| 210 Family Chiropractic Center Llc | |
|
163 Hampton Point Dr Suite 4 Saint Augustine FL 32092-3059 | |
| (904) 230-2717 | |
| (904) 230-2720 |
| Full Name | 210 Family Chiropractic Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 163 Hampton Point Dr, Saint Augustine, Florida |
| Authorized Official Name and Position | Agostinho M Oliveira (OWNER) |
| Authorized Official Contact | 9042302717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 210 Family Chiropractic Center Llc 163 Hampton Point Dr Suite 4 Saint Augustine FL 32092-3059 Ph: (904) 230-2717 | 210 Family Chiropractic Center Llc 163 Hampton Point Dr Suite 4 Saint Augustine FL 32092-3059 Ph: (904) 230-2717 |
| NPI Number | 1437364320 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8224136460 |
|---|---|
| Medicare Enrollment ID | O20070612000089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437364320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Agostinho Oliveira |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285729871 PECOS PAC ID: 1951379502 Enrollment ID: I20070509000366 |
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