Alfredo T Lim Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103556 Issued in FL

Practice address

947 Town Center Dr
Suite1341
Orange City, FL 32763-8361

Phone

(386) 917-0075

Fax

(386) 917-0655

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Alfredo T Lim Jr. Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1952365926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 WINGBACK CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464869",
            "telephone_number": "407-324-6901",
            "fax_number": "386-917-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 TOWN CENTER DR",
            "address_2": "SUITE1341",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638361",
            "telephone_number": "386-917-0075",
            "fax_number": "386-917-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "ALFREDO",
        "middle_name": "T",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALFREDO",
            "last_name": "LIM",
            "middle_name": "T",
            "suffix": "JR.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physician Assistant in Orange City, FL
• Providers in Orange City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.