Provider Demographics
NPI:1811347206
Name:SHIMABUKURO, CATARINA ISABEL LOPES
Entity type:Individual
Prefix:
First Name:CATARINA ISABEL
Middle Name:LOPES
Last Name:SHIMABUKURO
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 1:826 S KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3009
Mailing Address - Country:US
Mailing Address - Phone:808-523-9043
Mailing Address - Fax:808-526-0673
Practice Address - Street 1:826 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3009
Practice Address - Country:US
Practice Address - Phone:808-523-9043
Practice Address - Fax:808-526-0673
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-4198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist