Provider Demographics
NPI:1417181264
Name:LIMA, ROBERTA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:
Last Name:LIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:226 S WOODS MILL RD
Mailing Address - Street 2:SUITE 37W
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3662
Mailing Address - Country:US
Mailing Address - Phone:314-523-5300
Mailing Address - Fax:314-434-3191
Practice Address - Street 1:226 S WOODS MILL RD
Practice Address - Street 2:SUITE 37W
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3662
Practice Address - Country:US
Practice Address - Phone:314-523-5300
Practice Address - Fax:314-434-3191
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011038213207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology