Healthcare Provider Details

I. General information

NPI: 1265089619
Provider Name (Legal Business Name): KATRYNA LIM M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 NW 84TH AVE
SUNRISE FL
33351-6607
US

IV. Provider business mailing address

7301 LEMON GRASS DR
PARKLAND FL
33076-3950
US

V. Phone/Fax

Practice location:
  • Phone: 954-748-3039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATRYNA LIM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-695-3245