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General NPI Number Information
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NPI Number | 1306029913
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Entity Type | Organization
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Legal Business Name | DONALD A BASEMAN P A
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 9410 FOUNTAIN MEDICAL CT #A102
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4525
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Country | US
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Telephone | 239-948-9600
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Fax | 239-274-5007
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Provider Business Mailing Address
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Address Line | 9410 FOUNTAIN MEDICAL CT #A102
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4525
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Country | US
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Telephone | 239-948-9600
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Fax | 239-274-5007
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ANGELIQUE HAAS
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Credential |
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Telephone | 239-274-5004
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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 | OS0007431
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License Number State | FL
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