MEDICARE: MARIETA LIMA FNP-BC

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	363LF0000X	Family Nurse Practitioner	ARNP9206739	FL

General Provider Information

NPI Number	:	1760928287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIETA LIMA FNP-BC

Provider Business Mailing Address
First Line	:	9336 SW 35TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4116
Country	:	US
Telephone Number	:	305-582-0166
Fax Number	:

Provider Business Practice Location Address
First Line	:	9336 SW 35TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4116
Country	:	US
Telephone Number	:	305-582-0166
Fax Number	:

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

Provider Enumeration Date	:	01/08/2017
Last Update Date	:	01/08/2017

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