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General NPI Number Information
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NPI Number | 1508513136
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Entity Type | Organization
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Legal Business Name | FLORA MEDINA-MANUEL, M.D., INC.
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 2153 N KING ST STE 325
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City | HONOLULU
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State | HI
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Zip | 96819-4560
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Country | US
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Telephone | 808-845-7173
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Fax | 808-845-7173
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Provider Business Mailing Address
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Address Line | 2153 N KING ST STE 325
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City | HONOLULU
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State | HI
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Zip | 96819-4560
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Country | US
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Telephone | 808-845-7173
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Fax | 808-841-8599
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FLORA MEDINA-MANUEL
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Credential | MD
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Telephone | 808-845-7173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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