Provider Demographics
NPI:1386641009
Name:DINUNZIO, SHIELA MARIE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:SHIELA
Middle Name:MARIE
Last Name:DINUNZIO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:SHIELA
Other - Middle Name:MARIE
Other - Last Name:ROBISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:411 HUKU LII PL STE 101
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7062
Mailing Address - Country:US
Mailing Address - Phone:808-879-0077
Mailing Address - Fax:808-879-0177
Practice Address - Street 1:411 HUKU LII PL STE 101
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7062
Practice Address - Country:US
Practice Address - Phone:808-879-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005308225100000X
HI4804225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010089719Medicaid
VA010089719Medicaid