Individual
KASSIM KARL BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3730 GATLIN WOODS DR, ORLANDO, FL 32812-7610
(855) 832-6727
Mailing address
4575 SE DIXIE HWY, STUART, FL 34997-6826
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
Primary
—
FL
Other
Enumeration date
12/05/2017
Last updated
04/27/2018
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