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Individual

MR. BASSAN JORGE ALLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
8925 COLONIAL CENTER DR STE 1000, FORT MYERS, FL 33905-7813
(239) 343-7400
(239) 468-7942
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(393) 437-4002
(239) 468-7942

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
ME111167
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025065300
FL
Enumeration date
03/21/2009
Last updated
01/22/2025
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