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NPI 1679351787

NPI 1679351787 : ZOLI FISTES PT, DPT : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1679351787
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    Entity Type          |    Individual 
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    Provider Name        |    ZOLI FISTES PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/19/2023
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    Last Update Date     |    09/19/2023
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Provider Practice Location Address
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    Address Line         |    1314 KALAKAUA AVE FL 2 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96826-1900
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    Country              |    US
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    Telephone            |    808-372-1114
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2757 
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    City                 |    KAILUA KONA
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    State                |    HI
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    Zip                  |    96745-2757
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    Country              |    US
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    Telephone            |    808-372-1114
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT-5774
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    License Number State |    HI
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