Basic Information
| Provider Information | |||||||||
| NPI: | 1649431909 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOX BEHRLE | ||||||||
| FirstName: | VICTORIA | ||||||||
| MiddleName: | FELIZ | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., M.P.H. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FOX-BEHRLE | ||||||||
| OtherFirstName: | VICTORIA | ||||||||
| OtherMiddleName: | FELIZ | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D., MPH | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 75-5751 KUAKINI HWY STE 104 | ||||||||
| Address2: | |||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967401705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 68-1845 WAIKOLOA RD | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | WAIKOLOA VILLAGE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967439674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087695160 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2008 | ||||||||
| LastUpdateDate: | 11/24/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | MD.30024 | AL | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | MD.60297890 | WA | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | MD-19669 | HI | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.