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General NPI Number Information
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NPI Number | 1922113232
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Entity Type | Individual
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Provider Name | ROY G BASSETT JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 1445 N COURTENAY PKWY STE 101
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-4410
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Country | US
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Telephone | 561-810-1777
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Fax | 561-810-1866
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Provider Business Mailing Address
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Address Line | 601 S HARBOUR ISLAND BLVD STE 200
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City | TAMPA
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State | FL
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Zip | 33602-5925
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Country | US
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Telephone | 727-322-3439
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Fax | 800-928-7449
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME66781
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License Number State | FL
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