MEDICARE: MAXIMILIANO TAPIA

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1366234643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAXIMILIANO TAPIA

Provider Business Mailing Address
First Line	:	809 E 29TH ST # NEUSA
Second Line	:
City	:	SOUTH SIOUX CITY
State	:	NE
Zip	:	68776-3345
Country	:	US
Telephone Number	:	402-321-3637
Fax Number	:

Provider Business Practice Location Address
First Line	:	809 E 29TH ST # NEUSA
Second Line	:
City	:	SOUTH SIOUX CITY
State	:	NE
Zip	:	68776-3345
Country	:	US
Telephone Number	:	402-321-3637
Fax Number	:

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

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	05/21/2025

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Directions to “ MAXIMILIANO TAPIA ” Practice Location

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