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General NPI Number Information
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NPI Number | 1801866918
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Entity Type | Individual
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Provider Name | LARISSA A LIM MD
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 4343 W NEWBERRY RD SUITE 13
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City | GAINESVILLE
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State | FL
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Zip | 32607-2817
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Country | US
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Telephone | 352-332-7770
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Fax | 352-332-1119
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Provider Business Mailing Address
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Address Line | 4881 NW 8TH AVE SUITE 2
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City | GAINESVILLE
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State | FL
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Zip | 32605-4582
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Country | US
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Telephone | 352-373-6338
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Fax | 352-373-6144
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME79437
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | ME0079437
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License Number State | FL
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