Provider Demographics
NPI:1538443916
Name:ZURITA, GERARDO
Entity type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:ZURITA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 KAPAHULU AVE
Mailing Address - Street 2:APT. # 103
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1304
Mailing Address - Country:US
Mailing Address - Phone:808-989-3590
Mailing Address - Fax:
Practice Address - Street 1:1003 KAPAHULU AVE
Practice Address - Street 2:APT. # 103
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1304
Practice Address - Country:US
Practice Address - Phone:808-989-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst