# ROGER E BASSIN MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bassin Center for Eyelid and Facial Plastic Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588849780
- **Authorized official:** ROGER E BASSIN M.D. (OWNER/OPERATOR)
- **Authorized official phone:** (321) 255-0025

## Contact information

- **Practice address:** 1705 BERGLUND LN, SUITE 103, VIERA, FL 32940-6231
- **Practice address phone:** (321) 255-0025
- **Practice address fax:** (321) 255-0027
- **Mailing address:** 1705 BERGLUND LN, SUITE 103, VIERA, FL 32940-6231
- **Mailing address phone:** (321) 255-0025
- **Mailing address fax:** (321) 255-0027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME85585 | FL | — |
| 208200000X | Plastic Surgery Physician | ME85585 | FL | — |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | ME85585 | FL | Yes |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | ME85585 | FL | — |

## Other

- **Enumeration date:** 01/07/2008
- **Last updated:** 07/17/2024