Provider Demographics
NPI:1215203450
Name:DE LIMA, MORGAN (PT)
Entity type:Individual
Prefix:MR
First Name:MORGAN
Middle Name:
Last Name:DE LIMA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-370 PUPUPANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2657
Mailing Address - Country:US
Mailing Address - Phone:808-676-7700
Mailing Address - Fax:808-676-7708
Practice Address - Street 1:94-370 PUPUPANI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2657
Practice Address - Country:US
Practice Address - Phone:808-676-7700
Practice Address - Fax:808-676-7708
Is Sole Proprietor?:No
Enumeration Date:2012-03-31
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist