MEDICARE: ALEX LIMA PTA

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	225200000X	Physical Therapy Assistant	PTA27621	FL

General Provider Information

NPI Number	:	1356948905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX LIMA PTA

Provider Business Mailing Address
First Line	:	22017 PALMS WAY APT 205
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-8030
Country	:	US
Telephone Number	:	954-815-6840
Fax Number	:

Provider Business Practice Location Address
First Line	:	3891 STIRLING RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-6216
Country	:	US
Telephone Number	:	954-416-2444
Fax Number	:

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

Provider Enumeration Date	:	10/07/2020
Last Update Date	:	10/07/2020

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