Healthcare Provider Details

I. General information

NPI: 1447346150
Provider Name (Legal Business Name): GLORIFIN LARDIZABAL BELMONTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2239 N. SCHOOL STREET
HONOLULU HI
96819
US

IV. Provider business mailing address

2239 N. SCHOOL STREET
HONOLULU HI
96819
US

V. Phone/Fax

Practice location:
  • Phone: 808-791-9425
  • Fax: 808-847-1144
Mailing address:
  • Phone: 808-791-9425
  • Fax: 808-847-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberHI MD 4661
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMDHAWAII4661
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: