Provider Demographics
NPI:1578193934
Name:MADRID, LOVE JOY ANTONIO
Entity Type:Individual
Prefix:MRS
First Name:LOVE JOY
Middle Name:ANTONIO
Last Name:MADRID
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 1:91-129 APUU PL
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3915
Mailing Address - Country:US
Mailing Address - Phone:808-744-5793
Mailing Address - Fax:808-744-5793
Practice Address - Street 1:91-129 APUU PL
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3915
Practice Address - Country:US
Practice Address - Phone:808-744-5793
Practice Address - Fax:808-744-5793
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide