MEDICARE: MATTHEW K LIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	ME46175	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME46175	OTHER	FL	FLORIDA LICENSE

General Provider Information

NPI Number	:	1093988206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW K LIM MD

Provider Business Mailing Address
First Line	:	150 NW 70TH AVE
Second Line	:	SUITE 10
City	:	PLANTATION
State	:	FL
Zip	:	33317-2911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 NW 70TH AVE
Second Line	:	SUITE 10
City	:	PLANTATION
State	:	FL
Zip	:	33317-2911
Country	:	US
Telephone Number	:	954-583-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	04/09/2008

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Directions to “ MATTHEW K LIM MD” Practice Location

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