Healthcare Provider Details

I. General information

NPI: 1205708377
Provider Name (Legal Business Name): BODY MIND AND SOUL SPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 S BERETANIA ST
HONOLULU HI
96813-2220
US

IV. Provider business mailing address

31 S BERETANIA ST
HONOLULU HI
96813-2220
US

V. Phone/Fax

Practice location:
  • Phone: 808-524-8588
  • Fax: 720-836-6369
Mailing address:
  • Phone: 808-524-8588
  • Fax: 720-836-6369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JHEROLD PIZARRO
Title or Position: PRESIDENT/OWNER
Credential: LMT
Phone: 808-260-3731