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General NPI Number Information
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NPI Number | 1932583184
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Entity Type | Organization
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Legal Business Name | DR. ROY BASSETT ,MD, PL
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 1300 NW 17TH AVE 101
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City | DELRAY BEACH
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State | FL
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Zip | 33445-2578
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Country | US
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Telephone | 954-655-8824
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 NW 17 AVE 101
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City | DELRAY BEACH
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State | FL
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Zip | 33445
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Country | US
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Telephone | 954-655-8824
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DR. ROY BASSETT
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Credential | MD
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Telephone | 954-655-8824
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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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