This dish originates from French Polynesia (Tahiti) where the fish is served nearly raw with perhaps 15-20 minutes of marinating time in lime juice—which is easier to do when you catch the fish (typically tuna) the same day and keep it on ice. From my restaurant experience in the French Antilles, the fish seems to have been marinated a bit longer, perhaps 30-60 minutes. If the fish you will use was caught during the last few days (not few hours) and is not super fresh from the sea, better to marinate it in lime juice a bit longer, for 1 hour and up to 2 hours, the longer it marinates the more cooked it will be and the stronger the lime flavor. 
Prep Time: 20 Minutes
Marinating Time: Varies from 30 minutes to 1 hour
Serves: 2 as a meal, 4 as an appetizer.
Ingredients:
1 pound fresh snapper (or ahi tuna, or other sushi-grade fish), diced into ½-inch cubes
4 limes juiced (barely enough juice to cover most of the fish in a bowl)
¼ medium red onion, minced
½ red bell pepper, seeds and membranes removed, diced finely
½ teaspoon sea salt
¼ teaspoon freshly ground black pepper
1 medium Haas avocado, sliced into ½-inch cubes
4-6 ounces coconut milk (chilled in the refrigerator)
2 tablespoons cilantro (or parsley), chopped
4-8 fresh lettuce leaves (or encircle the plate with endive leaves)
Optional garnish, dash of cayenne (less than 1/8 of a teaspoon), or use paprika
Directions:
Marinate cubed fish in a bowl with lime juice in the refrigerator for 30 minutes with an occasional stir and up to 1 hour as desired to your taste. Add onion, red bell pepper, salt and black pepper and return to the refrigerator, and marinate another 10 minutes.
Add avocado, coconut milk, and cilantro, stir gently and serve on a bed of lettuce. Garnish with a dash of cayenne, or if you prefer less heat use paprika.
Enjoy,
Steven Masley, MD
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I am a food adventurer, but raw fish is something I’ve never eaten. I would love for you to comment on how the lime juice makes this safe to eat. How does one not get parasites or harmful bacteria from this? I assume the idea is that the lime juice is acidic enough to kill any pathogens. Are there studies that show this? Thank you.
Hi Kristel,
Yes the lime juice really does cook the fish chemically. To be fully cooked, for this recipe, I would recommend 90 minutes, which is likely a longer cooking process than you would use to cook your fish with heat if it was fresh. Only 30 minutes would be similar to searing tuna and having it red (partially raw on the inside). In a restaurant they would add a warning with seared tuna at the bottom of the menu regarding risks of eating raw seafood.
Just curious, do you ever eat sushi or sashimi? That would be far more risky than eating ceviche as then the fish is truly raw.
All the best, Steven Masley, MD
Steven Masley, MD