Provider Demographics
NPI:1942253109
Name:ABEYTA, CARLOS R (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:R
Last Name:ABEYTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:R
Other - Last Name:ABEYTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, LLC
Mailing Address - Street 1:82 PUUHONU PL
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2010
Mailing Address - Country:US
Mailing Address - Phone:808-969-9888
Mailing Address - Fax:808-969-9881
Practice Address - Street 1:82 PUUHONU PL
Practice Address - Street 2:SUITE 206
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2010
Practice Address - Country:US
Practice Address - Phone:808-969-9888
Practice Address - Fax:808-969-9881
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIG58274Medicare UPIN