MEDICARE: BASSEL RAMADAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	053386	GA
2	207RP1001X	Pulmonary Disease Physician	ME87777	FL
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME87777	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487603361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BASSEL RAMADAN MD

Provider Business Mailing Address
First Line	:	13933 17TH ST STE 201
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33525-4604
Country	:	US
Telephone Number	:	352-437-6035
Fax Number	:	352-437-4730

Provider Business Practice Location Address
First Line	:	13933 17TH ST STE 201
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33525-4604
Country	:	US
Telephone Number	:	352-437-6035
Fax Number	:	352-437-4730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	04/28/2021

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Directions to “ BASSEL RAMADAN MD” Practice Location

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