Provider Demographics
NPI:1255751202
Name:DR MARITZA LIMA
Entity type:Organization
Organization Name:DR MARITZA LIMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:305-557-5752
Mailing Address - Street 1:5791B NW 151ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2490
Mailing Address - Country:US
Mailing Address - Phone:305-557-5752
Mailing Address - Fax:305-556-4929
Practice Address - Street 1:5791B NW 151ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2490
Practice Address - Country:US
Practice Address - Phone:305-557-5752
Practice Address - Fax:305-556-4929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8534103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54447OtherPTAN/OSCAR/LEGACY