Provider Demographics
NPI:1689616500
Name:TRIPLETT, BEATA MARIE BASILIO (MPT)
Entity Type:Individual
Prefix:MRS
First Name:BEATA MARIE
Middle Name:BASILIO
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:BEATA MARIE
Other - Middle Name:CRUZ
Other - Last Name:BASILIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1001 KAMOKILA BLVD.,
Mailing Address - Street 2:STE 114
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2014
Mailing Address - Country:US
Mailing Address - Phone:808-674-9595
Mailing Address - Fax:808-674-9696
Practice Address - Street 1:1001 KAMOKILA BLVD.,
Practice Address - Street 2:STE 114
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2014
Practice Address - Country:US
Practice Address - Phone:808-674-9595
Practice Address - Fax:808-674-9696
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 32709225100000X
FLPT21903225100000X
HIPT 2723225100000X
HIPT-2723225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist