Provider Demographics
NPI:1487268488
Name:LIMA, ANA LUIZA GARCIA
Entity type:Individual
Prefix:
First Name:ANA LUIZA
Middle Name:GARCIA
Last Name: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 1:3540 W HILLSBORO BLVD APT 107
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2114
Mailing Address - Country:US
Mailing Address - Phone:978-413-4132
Mailing Address - Fax:
Practice Address - Street 1:9000 BURMA RD STE 109
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1606
Practice Address - Country:US
Practice Address - Phone:561-508-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-07
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-65354103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113757300Medicaid