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General NPI Number Information
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NPI Number | 1669308607
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Entity Type | Individual
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Provider Name | JUAN BERNAL DPT
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Gender | Male
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 2650 N TENAYA WAY STE 180
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City | LAS VEGAS
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State | NV
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Zip | 89128-1110
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Country | US
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Telephone | 702-240-1952
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Fax | 702-243-0482
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Provider Business Mailing Address
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Address Line | 7241 PAINTED SHADOWS WAY
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City | LAS VEGAS
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State | NV
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Zip | 89149-6459
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Country | US
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Telephone | 702-203-4115
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7031
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License Number State | NV
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