Individual
HAE SOO LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3627 UNIVERSITY BLVD S, SUITE 200, JACKSONVILLE, FL 32216-4230
(904) 296-3200
(904) 296-0069
Mailing address
PO BOX 25317, TAMPA, FL 33622-5317
(813) 286-0033
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME76129
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256547100
—
FL
01
—
44371
BC/BS
FL
01
—
5625622
AETNA
FL
Enumeration date
09/01/2006
Last updated
10/21/2019
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