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General NPI Number Information
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NPI Number | 1326440868
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Entity Type | Organization
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Legal Business Name | WESLEY CHAPEL NEUROLOGY, P.A.
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 28945 STATE ROAD 54 SUITE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543
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Country | US
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Telephone | 813-973-4563
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Fax | 813-973-4532
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Provider Business Mailing Address
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Address Line | 28945 STATE ROAD 54 SUITE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543
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Country | US
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Telephone | 813-973-4563
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Fax | 813-973-4532
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH BASI
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Credential | ARNP
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Telephone | 813-973-4563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP3154412
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License Number State | FL
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