Healthcare Provider Details

I. General information

NPI: 1497845937
Provider Name (Legal Business Name): LEONARDO ACOSTA CORTEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76-6225 KUAKINI HWY SUITE A107
KAILUA KONA HI
96740-3211
US

IV. Provider business mailing address

PO BOX 1969
KEALAKEKUA HI
96750-1969
US

V. Phone/Fax

Practice location:
  • Phone: 808-326-1944
  • Fax: 808-326-1584
Mailing address:
  • Phone: 808-326-1944
  • Fax: 808-326-7103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number5554
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: