Healthcare Provider Details

I. General information

NPI: 1275464513
Provider Name (Legal Business Name): LAIS DA SILVA LIMA MS, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2863 WIDEWATER WAY
ZEPHYRHILLS FL
33541-8471
US

IV. Provider business mailing address

2863 WIDEWATER WAY
ZEPHYRHILLS FL
33541-8471
US

V. Phone/Fax

Practice location:
  • Phone: 352-769-7963
  • Fax:
Mailing address:
  • Phone: 352-769-7963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberND15009
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: