MEDICARE: WILFREDO LIMAS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9274036	FL

General Provider Information

NPI Number	:	1083373377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILFREDO LIMAS RN

Provider Business Mailing Address
First Line	:	2993 W 80TH ST APT 11
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-7244
Country	:	US
Telephone Number	:	786-427-0124
Fax Number	:

Provider Business Practice Location Address
First Line	:	4672 NW 97TH PL
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33178-1967
Country	:	US
Telephone Number	:	786-953-5026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2021
Last Update Date	:	12/14/2021

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