Provider Demographics
NPI:1285184796
Name:SUMMER BREEZE LLC
Entity Type:Organization
Organization Name:SUMMER BREEZE LLC
Other - Org Name:BEATA SUMMER-BRASON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEATA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMER-BRASON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:808-220-7017
Mailing Address - Street 1:4211 WAIALAE AVE #202
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5319
Mailing Address - Country:US
Mailing Address - Phone:808-220-7017
Mailing Address - Fax:
Practice Address - Street 1:4211 WAIALAE #202
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5319
Practice Address - Country:US
Practice Address - Phone:808-220-7017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS 1195208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty