Provider Demographics
NPI:1235981341
Name:QUIROS, SANDRA CAROLINA
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:CAROLINA
Last Name:QUIROS
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:PO BOX 377505
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96737-7505
Mailing Address - Country:US
Mailing Address - Phone:808-205-1962
Mailing Address - Fax:
Practice Address - Street 1:92-9023 TREE FERN LN
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96704
Practice Address - Country:US
Practice Address - Phone:808-205-1962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIA128344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi