Healthcare Provider Details

I. General information

NPI: 1174679443
Provider Name (Legal Business Name): HAWAII RADIOLOGIC ASSOCIATES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/02/2025
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 PONAHAWAI ST. SUITE 110
HILO HI
96720
US

IV. Provider business mailing address

688 KINOOLE ST. SUITE 103
HILO HI
96720
US

V. Phone/Fax

Practice location:
  • Phone: 808-933-2540
  • Fax: 808-961-9236
Mailing address:
  • Phone: 808-935-1825
  • Fax: 808-935-8362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: STACEY AGUIAR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 808-935-1825