MEDICARE: JONATHAN FLEMING DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner	3180	HI

General Provider Information

NPI Number	:	1063163269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN FLEMING DPT

Provider Business Mailing Address
First Line	:	1514 PALOLO AVE APT G
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-2578
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1808 S BERETANIA ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96826-1305
Country	:	US
Telephone Number	:	808-342-8222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	01/10/2022

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Directions to “ JONATHAN FLEMING DPT” Practice Location

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