MEDICARE: BRANDON MAURICIO SORTO COREAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	898919	NV

General Provider Information

NPI Number	:	1679401251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON MAURICIO SORTO COREAS

Provider Business Mailing Address
First Line	:	110 W CHICAGO AVE APT A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2870
Country	:	US
Telephone Number	:	702-328-1497
Fax Number	:

Provider Business Practice Location Address
First Line	:	3087 E WARM SPRINGS RD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3754
Country	:	US
Telephone Number	:	702-463-1260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ BRANDON MAURICIO SORTO COREAS ” Practice Location

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