Individual
RENEE MARIE BASSALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3617 W HAMILTON AVE, TAMPA, FL 33614-4055
(813) 467-4265
(813) 467-4267
Mailing address
3617 W HAMILTON AVE, TAMPA, FL 33614-4055
(813) 467-4265
(813) 467-4267
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
OS10371
FL
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
OS10371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003665900
—
FL
Enumeration date
06/13/2008
Last updated
08/06/2021
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