Provider Demographics
NPI:1902286156
Name:LIM, ERIC CHUA (DPT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CHUA
Last Name:LIM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:4708 RED WARBLER LN
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-7906
Mailing Address - Country:US
Mailing Address - Phone:813-967-1399
Mailing Address - Fax:
Practice Address - Street 1:2926 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5627
Practice Address - Country:US
Practice Address - Phone:813-381-4944
Practice Address - Fax:813-381-3608
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT113282251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics