Provider Demographics
NPI:1740929975
Name:CADELINIA, JUN BRADLEY LESTINO (PT, DPT)
Entity type:Individual
Prefix:
First Name:JUN BRADLEY
Middle Name:LESTINO
Last Name:CADELINIA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-650 PUA ALOWALO ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2926
Mailing Address - Country:US
Mailing Address - Phone:808-203-4467
Mailing Address - Fax:
Practice Address - Street 1:1001 KAMOKILA BLVD STE 114
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2095
Practice Address - Country:US
Practice Address - Phone:808-674-0500
Practice Address - Fax:808-674-0511
Is Sole Proprietor?:No
Enumeration Date:2022-06-04
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-5460-0225100000X
HIPT5460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist