Healthcare Provider Details

I. General information

NPI: 1790551182
Provider Name (Legal Business Name): ARIEL LIMA SR. RN, APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NW 79TH AVE
DORAL FL
33122-1174
US

IV. Provider business mailing address

18860 NW 12TH ST
PEMBROKE PINES FL
33029-2944
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-1000
  • Fax:
Mailing address:
  • Phone: 305-450-5039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11029515
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: