MEDICARE: DR. JOAQUIN VELOSO LIM O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4120/T1088	OH
2	152W00000X	Optometrist	1432/P749A	AZ
3	152WC0802X	Corneal and Contact Management Optometrist	4120	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568541407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAQUIN VELOSO LIM O.D.

Provider Business Mailing Address
First Line	:	13545 EUCLID AVE
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-4205
Country	:	US
Telephone Number	:	216-451-4400
Fax Number	:	216-451-1424

Provider Business Practice Location Address
First Line	:	13545 EUCLID AVE
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-4205
Country	:	US
Telephone Number	:	216-451-4400
Fax Number	:	216-451-1424

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	09/11/2025

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