MEDICARE: MR. CHAD ROBERT BASS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	APRN9258111	FL

General Provider Information

NPI Number	:	1922441146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD ROBERT BASS CRNA

Provider Business Mailing Address
First Line	:	2727 W DR MARTIN LUTHER KING JR BLVD STE 310
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6063
Country	:	US
Telephone Number	:	800-394-4445
Fax Number	:	706-650-1034

Provider Business Practice Location Address
First Line	:	2727 W DR MARTIN LUTHER KING JR BLVD
Second Line	:	SUITE 310
City	:	TAMPA
State	:	FL
Zip	:	33607-6383
Country	:	US
Telephone Number	:	800-394-4445
Fax Number	:	706-650-1034

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

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	01/26/2026

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