Healthcare Provider Details

I. General information

NPI: 1982275905
Provider Name (Legal Business Name): BENJAMIN LIM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6563 STATE ROAD 54
NEW PORT RICHEY FL
34653-6003
US

IV. Provider business mailing address

150 LIFESTYLE BLVD APT 215
PALM HARBOR FL
34684-3633
US

V. Phone/Fax

Practice location:
  • Phone: 727-380-9181
  • Fax:
Mailing address:
  • Phone: 334-372-9602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: