Provider Demographics
NPI:1174570824
Name:SORIANO, BERNARDO BERNARDO (MPT)
Entity type:Individual
Prefix:MR
First Name:BERNARDO
Middle Name:BERNARDO
Last Name:SORIANO
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-416 HOIO PL
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3528
Mailing Address - Country:US
Mailing Address - Phone:808-676-8045
Mailing Address - Fax:
Practice Address - Street 1:916 A KILANI AVE
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2396
Practice Address - Country:US
Practice Address - Phone:808-621-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist