Healthcare Provider Details

I. General information

NPI: 1942291364
Provider Name (Legal Business Name): VINCENTE S RAMO MD PC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N KING ST SUITE 108
HONOLULU HI
96819-3479
US

IV. Provider business mailing address

2055 N KING ST SUITE 108
HONOLULU HI
96819-3479
US

V. Phone/Fax

Practice location:
  • Phone: 808-841-7288
  • Fax: 808-841-8841
Mailing address:
  • Phone: 808-841-7288
  • Fax: 808-841-8841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10117
License Number StateHI

VIII. Authorized Official

Name: DR. VINCENTE SEPARA RAMO JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 808-841-7288