Provider Demographics
NPI:1417460841
Name:CLAROS, RODEL CAMARENEZ (LMT)
Entity Type:Individual
Prefix:
First Name:RODEL
Middle Name:CAMARENEZ
Last Name:CLAROS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:ARCE
Other - Middle Name:CAMARENEZ
Other - Last Name:CLAROS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:932 WARD AVE FL 6
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2131
Mailing Address - Country:US
Mailing Address - Phone:808-535-5555
Mailing Address - Fax:
Practice Address - Street 1:932 WARD AVE FL 6
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2131
Practice Address - Country:US
Practice Address - Phone:808-535-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-13754225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist