Healthcare Provider Details

I. General information

NPI: 1720498470
Provider Name (Legal Business Name): JOSUE LIMAGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2014
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2789 S STATE ROAD 7 # 100200
WELLINGTON FL
33414-9359
US

IV. Provider business mailing address

2789 S STATE ROAD 7 STE 100200
WELLINGTON FL
33414-9359
US

V. Phone/Fax

Practice location:
  • Phone: 561-898-5100
  • Fax: 561-898-5101
Mailing address:
  • Phone: 561-898-5100
  • Fax: 561-898-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME129479
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: