Individual
BASSEM KOLEILAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 425-4542
(386) 425-7705
Mailing address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 226-4590
(386) 226-4577
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME102911
FL
208M00000X
Hospitalist Physician
Primary
ME102911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100933410
—
KY
Enumeration date
03/23/2007
Last updated
07/23/2024
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