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NPI Code Detail

MEDICARE: ROSA ICELA LUPERCIO

MEDICARE: ROSA ICELA LUPERCIO
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
1376J00000XHomemaker
2385H00000XRespite Care
33747P1801XPersonal Care Attendant
4253Z00000XIn Home Supportive Care Agency
5372600000XAdult Companion
63747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1225968134
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSA ICELA LUPERCIO
Provider Business Mailing Address
First Line : 2150 S EASTERN AVE STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-4109
Country : US
Telephone Number : 702-207-0842
Fax Number :
Provider Business Practice Location Address
First Line : 2150 S EASTERN AVE STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-4109
Country : US
Telephone Number : 702-207-0842
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2026
Last Update Date : 05/21/2026

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Directions to “ ROSA ICELA LUPERCIO ” Practice Location

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