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Organization
LEONARD C BASS MD PA
Active
Organization
LEONARD C BASS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD CHANNING BASS MD (PRESIDENT)
(954) 873-8545
Entity
Organization
Contact information
Practice address
9750 NW 45TH MNR, CORAL SPRINGS, FL 33065-1514
(954) 873-8545
(954) 587-7577
Mailing address
PO BOX 101330, FORT LAUDERDALE, FL 33310-1330
(954) 873-8545
(954) 587-7577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME14256
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373957100
—
FL
Enumeration date
09/05/2006
Last updated
05/25/2011
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