Provider Demographics
NPI:1801648522
Name:DY, MARC-ALLEN LIM (APRN)
Entity type:Individual
Prefix:
First Name:MARC-ALLEN
Middle Name:LIM
Last Name:DY
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10328 STALLION FIELDS WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3765
Mailing Address - Country:US
Mailing Address - Phone:813-919-9386
Mailing Address - Fax:
Practice Address - Street 1:10328 STALLION FIELDS WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3765
Practice Address - Country:US
Practice Address - Phone:813-919-9386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11025615363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology