Healthcare Provider Details

I. General information

NPI: 1588311195
Provider Name (Legal Business Name): ALOHA INFECTIOUS DISEASES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALA MOANA BLVD STE 5-300
HONOLULU HI
96813-4908
US

IV. Provider business mailing address

500 ALA MOANA BLVD STE 5-300
HONOLULU HI
96813-4908
US

V. Phone/Fax

Practice location:
  • Phone: 808-531-7111
  • Fax: 808-528-5507
Mailing address:
  • Phone: 808-531-7111
  • Fax: 808-528-5507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: TANYA FLORIN
Title or Position: BILLING MANAGER
Credential:
Phone: 808-228-5436