Provider Demographics
NPI:1568240737
Name:INFANTE LIMA, DAILY
Entity Type:Individual
Prefix:
First Name:DAILY
Middle Name:
Last Name:INFANTE LIMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 FORESTERIA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3307
Mailing Address - Country:US
Mailing Address - Phone:786-406-4939
Mailing Address - Fax:
Practice Address - Street 1:445 FORESTERIA DR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3307
Practice Address - Country:US
Practice Address - Phone:786-406-4939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-157021106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician