Basic Information
Provider Information
NPI: 1336686682
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIMA
FirstName: YANAISA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 743144
Address2:  
City: ATLANTA
State: GA
PostalCode: 303743144
CountryCode: US
TelephoneNumber: 7865962000
FaxNumber:  
Practice Location
Address1: 8900 N KENDALL DR
Address2:  
City: MIAMI
State: FL
PostalCode: 331762118
CountryCode: US
TelephoneNumber: 3055962000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/25/2017
LastUpdateDate: 10/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X9281328FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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