Provider Demographics
NPI:1427366475
Name:GEORGE T. LIM JR, M.D., P.A.
Entity Type:Organization
Organization Name:GEORGE T. LIM JR, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:LIM
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:954-804-0894
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53050173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty