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General NPI Number Information
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NPI Number | 1073293775
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Entity Type | Individual
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Provider Name | CHRISTOPHER BASCO
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Gender | Male
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 13715 RICHMOND PARK DR N UNIT 401
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City | JACKSONVILLE
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State | FL
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Zip | 32224-5277
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Country | US
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Telephone | 904-593-8514
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Fax | 904-593-8515
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Provider Business Mailing Address
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Address Line | 13715 RICHMOND PARK DR N UNIT 401
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City | JACKSONVILLE
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State | FL
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Zip | 32224-5277
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Country | US
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Telephone | 904-593-8514
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Fax | 904-593-8515
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | RN9353418
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11027433
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License Number State | FL
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