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Organization

INSTITUTE OF DERMATOLOGY & OCULOPLASTIC SURGERY PLLC

Active
Parent organization
INSTITUTE OF DERMATOLOGY & OCULOPLASTIC SURGERY
Organization subpart
Yes

Provider details

NPI number
Legal business name
INSTITUTE OF DERMATOLOGY & OCULOPLASTIC SURGERY
Authorized official
ILYA LIM MD (CO-OWNER)
(941) 499-0199
Entity
Organization

Contact information

Practice address
1617 S TUTTLE AVE FL 3, SARASOTA, FL 34239-3132
(941) 499-0199
(941) 200-4021
Mailing address
PO BOX 15853, SARASOTA, FL 34277-1853
(941) 499-0199
(941) 200-4021

Taxonomy

Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
207NS0135X
Procedural Dermatology Physician
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
261QX0200X
Oncology Clinic/Center
Primary

Other

Enumeration date
04/17/2022
Last updated
10/10/2023
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