=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972650760
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARON R MURILLO MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2007
-----------------------------------------------------
Last Update Date | 09/19/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1777 ALA MOANA BLVD APT 1113
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96815-1646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-419-3009
-----------------------------------------------------
Fax | 212-924-6165
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 57 CHRISTOPHER ST APT 4B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10014-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-419-3008
-----------------------------------------------------
Fax | 212-924-6165
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 232560
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------