Basic Information
| Provider Information | |||||||||
| NPI: | 1215010061 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIM | ||||||||
| FirstName: | NANCY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 830 WOODS LANDING DR | ||||||||
| Address2: | |||||||||
| City: | MINNEOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347156039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523216961 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8849 W COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | OCOEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347616951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8446654827 | ||||||||
| FaxNumber: | 8663697893 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 02/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E4965 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD27483 | AL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | ME95140 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.