Healthcare Provider Details

I. General information

NPI: 1538478086
Provider Name (Legal Business Name): NOB HILL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2010
Last Update Date: 10/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10098 W MCNAB RD
TAMARAC FL
33321-1895
US

IV. Provider business mailing address

10098 W MCNAB RD
TAMARAC FL
33321-1895
US

V. Phone/Fax

Practice location:
  • Phone: 954-724-9080
  • Fax: 954-724-4379
Mailing address:
  • Phone: 954-724-9080
  • Fax: 954-724-4379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME53050
License Number StateFL

VIII. Authorized Official

Name: DR. GEORGE T LIM JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-804-0894