Provider Demographics
NPI:1003878687
Name:LIM, GEORGE TAN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:TAN
Last Name:LIM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3505 NW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6607
Mailing Address - Country:US
Mailing Address - Phone:954-748-3039
Mailing Address - Fax:954-748-5358
Practice Address - Street 1:3505 NW 84TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6607
Practice Address - Country:US
Practice Address - Phone:954-748-3039
Practice Address - Fax:954-748-5358
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 53050173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine