Healthcare Provider Details

I. General information

NPI: 1932807393
Provider Name (Legal Business Name): RENATA LLOYD LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 N KALAHEO AVE STE C315
KAILUA HI
96734-1883
US

IV. Provider business mailing address

970 N KALAHEO AVE STE C315
KAILUA HI
96734-1883
US

V. Phone/Fax

Practice location:
  • Phone: 808-254-5577
  • Fax: 808-254-5579
Mailing address:
  • Phone: 808-254-5577
  • Fax: 808-254-5579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberEMT-3050
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-10434
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: