MEDICARE: JOYCE DE LIMA

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	390200000X	Student in an Organized Health Care Education/Training Program		MI

General Provider Information

NPI Number	:	1407784721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE DE LIMA

Provider Business Mailing Address
First Line	:	17385 HANNAN RD
Second Line	:
City	:	NEW BOSTON
State	:	MI
Zip	:	48164-9432
Country	:	US
Telephone Number	:	808-476-9108
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 N LINCOLN RD
Second Line	:
City	:	ESCANABA
State	:	MI
Zip	:	49829-4201
Country	:	US
Telephone Number	:	906-233-9477
Fax Number	:

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

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/12/2026

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Directions to “ JOYCE DE LIMA ” Practice Location

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