Individual
JAMIE EUDORA BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
501 LAPALCO BLVD, GRETNA, LA 70056-7336
(504) 393-4376
(504) 930-4307
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(305) 628-6117
(305) 393-5989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO.000463
LA
207Q00000X
Family Medicine Physician
OS19438
FL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
OS19438
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116598400
—
FL
Enumeration date
06/05/2012
Last updated
01/06/2026
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