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NPI Code Detail

MEDICARE: WALTER ANTONIO BRENES

MEDICARE: WALTER ANTONIO BRENES
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1447176391
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER ANTONIO BRENES
Provider Business Mailing Address
First Line : 3225 S RAINBOW BLVD UNIT 102-8
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6239
Country : US
Telephone Number : 702-463-0085
Fax Number :
Provider Business Practice Location Address
First Line : 3225 S RAINBOW BLVD UNIT 102-8
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6239
Country : US
Telephone Number : 702-463-0085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2026
Last Update Date : 06/25/2026

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Directions to “ WALTER ANTONIO BRENES ” Practice Location

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