Healthcare Provider Details
I. General information
NPI: 1225000151
Provider Name (Legal Business Name): ROLAND F. BESSIS, PHD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2006
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3400 CORAL WAY SUITE 601
MIAMI FL
33145-3070
US
IV. Provider business mailing address
939 HOLLYWOOD BLVD
HOLLYWOOD FL
33019-1605
US
V. Phone/Fax
- Phone: 305-538-5811
- Fax: 954-926-5804
- Phone: 954-926-7486
- Fax: 954-926-5804
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | PY0005053 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
ROLAND
F.
BESSIS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 954-926-7486