Provider Demographics
NPI:1811672231
Name:MOREIRA DE ARAUJO LIMA, AUGUSTO DARWIN
Entity type:Individual
Prefix:
First Name:AUGUSTO DARWIN
Middle Name:
Last Name:MOREIRA DE ARAUJO LIMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6472 MAKRUT LIME DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5080
Mailing Address - Country:US
Mailing Address - Phone:585-364-5372
Mailing Address - Fax:
Practice Address - Street 1:1085 N JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4210
Practice Address - Country:US
Practice Address - Phone:407-483-5797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN266061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics