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Combine the lime juice, cumin, paprika, garlic, salt, and pepper in a large bowl.
Add in the tilapia and mix until coated.
Cover and place in the refrigerator to marinate for 20 minutes or so.
Heat the olive oil in a large skillet or casserole over medium-high heat. Add the peppers and onions and cook until they begin to thaw, about 3 minutes.
Add the tomatoes and marinated tilapia and mix them in.
Pour the coconut milk over everything, mix and cover, and simmer about 20 minutes, stirring occasionally.
In the last few minutes, stir in the cilantro (optional).
When the tilapia is cooked through, garnish with additional cilantro (if desired) and serve.