Provider Demographics
NPI:1073650073
Name:DOCTOR, ESTRELITA AURELIO
Entity Type:Individual
Prefix:MRS
First Name:ESTRELITA
Middle Name:AURELIO
Last Name:DOCTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-2449
Mailing Address - Country:US
Mailing Address - Phone:808-847-4706
Mailing Address - Fax:808-847-4708
Practice Address - Street 1:2516 ROSE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-2449
Practice Address - Country:US
Practice Address - Phone:808-847-4706
Practice Address - Fax:808-847-4708
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI127766400699E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI57526901Medicaid