Provider Demographics
NPI:1366234643
Name:TAPIA, MAXIMILIANO
Entity type:Individual
Prefix:
First Name:MAXIMILIANO
Middle Name:
Last Name:TAPIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 E 29TH ST # NEUSA
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-3345
Mailing Address - Country:US
Mailing Address - Phone:402-321-3637
Mailing Address - Fax:
Practice Address - Street 1:809 E 29TH ST # NEUSA
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3345
Practice Address - Country:US
Practice Address - Phone:402-321-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker