Provider Demographics
NPI:1073936027
Name:SPERANDEO, THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:SPERANDEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57-101 W KUILIMA LOOP APT 163
Mailing Address - Street 2:
Mailing Address - City:KAHUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96731-2146
Mailing Address - Country:US
Mailing Address - Phone:808-349-5692
Mailing Address - Fax:848-210-9601
Practice Address - Street 1:57-101 W KUILIMA LOOP APT 163
Practice Address - Street 2:
Practice Address - City:KAHUKU
Practice Address - State:HI
Practice Address - Zip Code:96731-2146
Practice Address - Country:US
Practice Address - Phone:808-349-5692
Practice Address - Fax:848-210-9601
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5681207Q00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine