MEDICARE: JOSEPHINE B LIM MD PA

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	2084N0400X	Neurology Physician	ME80475	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295911196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPHINE B LIM MD PA

Provider Business Mailing Address
First Line	:	2404 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2214
Country	:	US
Telephone Number	:	863-802-8440
Fax Number	:	863-802-8310

Provider Business Practice Location Address
First Line	:	2404 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-2214
Country	:	US
Telephone Number	:	863-802-8440
Fax Number	:	863-802-8310

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPHINE BLANCHE LIM
Credential	:
Telephone Number	:	863-802-8440

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	01/10/2008

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