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General NPI Number Information
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NPI Number | 1831863810
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Entity Type | Individual
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Provider Name | EMBER COURTNEY-LIMA DMD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 963 37TH PL
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City | VERO BEACH
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State | FL
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Zip | 32960-6541
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Country | US
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Telephone | 352-235-9117
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Fax |
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Provider Business Mailing Address
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Address Line | 7714 LOUIS PASTEUR DR APT 1303
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3368
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Country | US
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Telephone | 772-559-3331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | ETN854
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN25951
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License Number State | FL
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