Provider Demographics
NPI:1962190017
Name:BERNARDINO, JULIAN FELIX
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:FELIX
Last Name:BERNARDINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 E BASELINE RD APT 2087
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4690
Mailing Address - Country:US
Mailing Address - Phone:480-849-4187
Mailing Address - Fax:
Practice Address - Street 1:8655 E VIA DE VENTURA STE E160
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3395
Practice Address - Country:US
Practice Address - Phone:714-875-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic