Healthcare Provider Details

I. General information

NPI: 1235678988
Provider Name (Legal Business Name): VFL MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92-8691 LOTUS BLOSSOM LANE 6&7
OCEAN VIEW HI
96737
US

IV. Provider business mailing address

PO BOX 269
KEALAKEKUA HI
96750-0269
US

V. Phone/Fax

Practice location:
  • Phone: 828-230-7471
  • Fax:
Mailing address:
  • Phone: 828-230-7471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberAPRN-2219
License Number StateHI

VIII. Authorized Official

Name: MS. MARINA M O'BRIEN-GAMBLE
Title or Position: APRN
Credential: APRN
Phone: 828-230-7471