MEDICARE: CAITLIN LIZBETH BASS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME144392	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841723780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN LIZBETH BASS M.D.

Provider Business Mailing Address
First Line	:	1700 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-3509
Country	:	US
Telephone Number	:	941-917-7799
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 HEALTH PARK BLVD STE 215
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-5797
Country	:	US
Telephone Number	:	904-824-3777
Fax Number	:	904-824-6050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2017
Last Update Date	:	06/30/2025

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