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General NPI Number Information
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NPI Number | 1134000391
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Entity Type | Organization
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Legal Business Name | RETINA INSTITUTE OF HAWAII LLC
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4418 KUKUI GROVE ST
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City | LIHUE
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State | HI
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Zip | 96766-1676
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Country | US
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Telephone | 808-955-0255
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Fax | 808-955-4155
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Provider Business Mailing Address
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Address Line | PO BOX 1300 MAILCODE 61323
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City | HONOLULU
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State | HI
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Zip | 96807-1300
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Country | US
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Telephone | 808-955-0255
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Fax | 808-955-4155
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Authorized Official
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Title or Position | MD/OWNER
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Name | MICHAEL DARREN BENNETT
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Credential |
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Telephone | 808-955-0255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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