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General NPI Number Information
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NPI Number | 1053544882
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Entity Type | Organization
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Legal Business Name | BASSEL RAMADAN MD PA
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 01/09/2010
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Provider Practice Location Address
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Address Line | 6817 SOUTHPOINT PKWY STE 1802
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6299
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Country | US
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Telephone | 904-371-2756
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Fax |
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Provider Business Mailing Address
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Address Line | 6817 SOUTHPOINT PKWY STE 1802
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6299
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Country | US
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Telephone | 904-371-2756
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. BASSEL RAMADAN
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Credential | MD
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Telephone | 904-371-2756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME87777
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License Number State | FL
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