Individual ProviderEdwell LimaBehavior AnalystBehavioral Health & Social Service ProvidersPractice Address2488 W 64th Pl, Hialeah, FL 33016-4386(800) 987-1209PECOS EnrollmentBased on the most recent information from CMS, provider Edwell Lima does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1689184996Provider TypeIndividualFull NameLima, EdwellGenderMaleSole ProprietorYesEnumeration Date10/2/2017Last Updated10/25/2024Contact InformationPractice LocationPractice Address2488 W 64th Pl, Hialeah, FL 33016-4386Phone(800) 987-1209Fax(305) 647-2160Mailing LocationMailing Address2488 W 64th Pl, Hialeah, FL 33016-4386Phone(800) 987-1209Fax(305) 647-2160Provider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicense1-18-32449FloridaProvider IdentifiersIDDescriptionIssuerID022455900DescriptionMedicaidIssuerUnlistedFlorida