Healthcare Provider Details

I. General information

NPI: 1669267241
Provider Name (Legal Business Name): BRAULIO RODAS MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LEO RODAS

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-326 MAHALANI ST
KANEOHE HI
96744-2728
US

IV. Provider business mailing address

45-326 MAHALANI ST
KANEOHE HI
96744-2728
US

V. Phone/Fax

Practice location:
  • Phone: 808-220-0969
  • Fax:
Mailing address:
  • Phone: 808-220-0969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-5571
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: