Provider Demographics
NPI:1912348103
Name:LIM, DONNABELLE LUCERO (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNABELLE
Middle Name:LUCERO
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18600 FERNVIEW ST # 102
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-6212
Mailing Address - Country:US
Mailing Address - Phone:813-692-8044
Mailing Address - Fax:813-605-6184
Practice Address - Street 1:18600 FERNVIEW ST # 102
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-6212
Practice Address - Country:US
Practice Address - Phone:813-692-8044
Practice Address - Fax:813-605-6184
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME126169207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program