Provider Demographics
NPI:1538211594
Name:VILORIA, MILAGROS USITA (CNA)
Entity type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:USITA
Last Name:VILORIA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 KALIHI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4252
Mailing Address - Country:US
Mailing Address - Phone:808-845-3602
Mailing Address - Fax:
Practice Address - Street 1:1939 KALIHI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4252
Practice Address - Country:US
Practice Address - Phone:808-845-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI122305790497E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI576259-01Medicaid