Healthcare Provider Details

I. General information

NPI: 1215454376
Provider Name (Legal Business Name): MATEUS CABRAL CECILIO LIMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N FLAMINGO RD
PEMBROKE PINES FL
33028-1014
US

IV. Provider business mailing address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US

V. Phone/Fax

Practice location:
  • Phone: 954-436-5000
  • Fax:
Mailing address:
  • Phone: 434-982-0629
  • Fax: 434-982-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101290715
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number342758
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME171124
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: