Provider Demographics
NPI:1023368610
Name:CARLOS R. ABEYTA MD, LLC
Entity Type:Organization
Organization Name:CARLOS R. ABEYTA MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABEYTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-969-9888
Mailing Address - Street 1:82 PUUHONU PL
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2010
Mailing Address - Country:US
Mailing Address - Phone:808-969-9888
Mailing Address - Fax:808-969-9881
Practice Address - Street 1:82 PUUHONU PL
Practice Address - Street 2:SUITE 206
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2010
Practice Address - Country:US
Practice Address - Phone:808-969-9888
Practice Address - Fax:808-969-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10054261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care