MEDICARE: LAURA 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	106S00000X	Behavior Technician		FL
2	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003541665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA TAPIA

Provider Business Mailing Address
First Line	:	3745 42ND AVE SE
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34117-9476
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5425 GOLDEN GATE PKWY STE 7
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34116-7524
Country	:	US
Telephone Number	:	239-778-8455
Fax Number	:

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

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	09/06/2022

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Directions to “ LAURA TAPIA ” Practice Location

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