Healthcare Provider Details

I. General information

NPI: 1437151461
Provider Name (Legal Business Name): DEBORA M. GAMA LIMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 E BELL RD SUITE 301
PHOENIX AZ
85032-2138
US

IV. Provider business mailing address

15600 N BLACK CANYON HWY SUITE 102-C
PHOENIX AZ
85053-4055
US

V. Phone/Fax

Practice location:
  • Phone: 602-995-0822
  • Fax: 602-995-0825
Mailing address:
  • Phone: 602-995-0822
  • Fax: 602-995-0825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number31899
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: