Individual
LEONARD CHANNING BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
398 CAMINO GARDENS BLVD, 102, BOCA RATON, FL 33432-5827
(561) 929-9104
(561) 392-3793
Mailing address
398 CAMINO GARDENS BLVD, 102, BOCA RATON, FL 33432-5827
(561) 929-9104
(561) 392-3793
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME14256
FL
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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