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NPI Code Detail

MEDICARE: AMELIA ELIZABETH BONILLA SORTO

MEDICARE:   AMELIA ELIZABETH BONILLA SORTO
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
1251E00000XHome Health Agency874267NV

General Provider Information

NPI Number : 1235963844
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA ELIZABETH BONILLA SORTO
Provider Business Mailing Address
First Line : 8821 FIRST LADY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-3894
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8821 FIRST LADY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-3894
Country : US
Telephone Number : 702-578-1259
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2024
Last Update Date : 08/27/2024

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Directions to “ AMELIA ELIZABETH BONILLA SORTO ” Practice Location

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