Provider Demographics
NPI:1609522044
Name:FAIRBANKS LIMA DE OLIVEIRA, FLAVIA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:FLAVIA
Middle Name:
Last Name:FAIRBANKS LIMA DE OLIVEIRA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8450 NW 102ND AVE APT 349
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4767
Mailing Address - Country:US
Mailing Address - Phone:786-561-5393
Mailing Address - Fax:
Practice Address - Street 1:1120 NW 14TH ST STE 1158
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2107
Practice Address - Country:US
Practice Address - Phone:305-689-8003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMFC1853207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty