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General NPI Number Information
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NPI Number | 1740929975
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Entity Type | Individual
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Provider Name | JUN BRADLEY LESTINO CADELINIA PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/04/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 1001 KAMOKILA BLVD STE 114
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City | KAPOLEI
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State | HI
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Zip | 96707-2095
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Country | US
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Telephone | 808-674-0500
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Fax | 808-674-0511
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Provider Business Mailing Address
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Address Line | 45-650 PUA ALOWALO ST
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City | KANEOHE
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State | HI
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Zip | 96744-2926
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Country | US
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Telephone | 808-203-4467
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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 | PT-5460-0
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT5460
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License Number State | HI
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