Healthcare Provider Details

I. General information

NPI: 1518592450
Provider Name (Legal Business Name): SUMA METLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 MAKALOA ST STE 920
HONOLULU HI
96814-3259
US

IV. Provider business mailing address

1580 MAKALOA ST STE 920
HONOLULU HI
96814-3259
US

V. Phone/Fax

Practice location:
  • Phone: 808-940-2051
  • Fax: 808-204-1700
Mailing address:
  • Phone: 808-940-2051
  • Fax: 808-204-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT30953
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4432
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: