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General NPI Number Information
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NPI Number | 1013945815
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Entity Type | Individual
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Provider Name | BASSAM ALTAJAR MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 425 NURSING HOME DR
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City | ARCADIA
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State | FL
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Zip | 34266-3839
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Country | US
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Telephone | 941-812-0896
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Fax |
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Provider Business Mailing Address
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Address Line | 425 NURSING HOME DR
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City | ARCADIA
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State | FL
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Zip | 34266-3839
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Country | US
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Telephone | 941-812-0896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease
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License Number | ME83500
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine
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License Number | ME83500
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine
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License Number | ME83500
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License Number State | FL
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