Provider Demographics
NPI:1154556280
Name:ACASIO, RODNEY VALDECANAS (IDMT)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:VALDECANAS
Last Name:ACASIO
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:111 KOPIKO ST.
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-5429
Mailing Address - Country:US
Mailing Address - Phone:808-474-4959
Mailing Address - Fax:808-474-4880
Practice Address - Street 1:310 WORCHESTER AVE BLDG 45
Practice Address - Street 2:
Practice Address - City:HICKAM AFB
Practice Address - State:HI
Practice Address - Zip Code:96853-5530
Practice Address - Country:US
Practice Address - Phone:808-474-4959
Practice Address - Fax:808-474-4880
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians