MEDICARE: JOSEPH ADAM WASSELLE 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	2086S0129X	Vascular Surgery Physician	ME172877	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	:	1598260754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH ADAM WASSELLE MD

Provider Business Mailing Address
First Line	:	240 N WICKHAM RD STE 311
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-8661
Country	:	US
Telephone Number	:	321-752-1660
Fax Number	:	321-752-1551

Provider Business Practice Location Address
First Line	:	240 N WICKHAM RD STE 311
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-8661
Country	:	US
Telephone Number	:	321-752-1660
Fax Number	:	321-752-1551

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

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	09/02/2025

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