Provider Demographics
NPI:1003133554
Name:EYELAND EYEDOC LLC
Entity Type:Organization
Organization Name:EYELAND EYEDOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEALIINANI
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUARTE-HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:808-933-4777
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-0707
Mailing Address - Country:US
Mailing Address - Phone:808-933-4777
Mailing Address - Fax:877-983-4777
Practice Address - Street 1:305 WAILUKU DR STE 4
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2488
Practice Address - Country:US
Practice Address - Phone:808-933-4777
Practice Address - Fax:877-983-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-691152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty