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Organization
RETINA INSTITUTE OF HAWAII LLC
Active
Organization
RETINA INSTITUTE OF HAWAII LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D BENNETT MD (OWNER FOUNDER)
(808) 955-0255
Entity
Organization
Contact information
Practice address
77-6403 NALANI ST FL 2, KAILUA KONA, HI 96740-9763
(808) 955-0255
(808) 955-4155
Mailing address
PO BOX 1300, MAILCODE 61323, HONOLULU, HI 96807-1300
(808) 955-0255
(808) 955-4155
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50433301
—
HI
Enumeration date
04/10/2006
Last updated
10/05/2023
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