Provider Demographics
NPI:1184157539
Name:LIM, ALEXANDER S (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:S
Last Name:LIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7015 A C SKINNER PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6932
Mailing Address - Country:US
Mailing Address - Phone:904-363-2113
Mailing Address - Fax:904-363-2606
Practice Address - Street 1:7015 A C SKINNER PKWY BLDG 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6932
Practice Address - Country:US
Practice Address - Phone:904-516-3737
Practice Address - Fax:904-516-3738
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2023-12-05
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME161380207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLVMRSSOtherFL BLUE
FL118330600Medicaid
FLQY489OtherMEDICARE