Organization
EDWARD BASS MD PA
Active
Organization
EDWARD BASS MD PA
Active
Other names
BASS & LIPENKO MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD BASS MD (PHYSICIAN/NEUROLOGY)
(813) 878-2800
Entity
Organization
Contact information
Practice address
4710 N HABANA AVE, SUITE 200, TAMPA, FL 33614-7161
(813) 878-2800
(813) 875-5213
Mailing address
4710 N HABANA AVE, SUITE 200, TAMPA, FL 33614-7161
(813) 878-2800
(813) 875-5213
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
S93186941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266696100
—
FL
01
—
DA1412
RAILROAD MEDICARE
—
Enumeration date
07/27/2005
Last updated
04/22/2010
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