Organization
ROGER E BASSIN MD PA
Active
Other names
Bassin Center for Eyelid and Facial Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER E BASSIN M.D. (OWNER/OPERATOR)
(321) 255-0025
Entity
Organization
Contact information
Practice address
1705 BERGLUND LN, SUITE 103, VIERA, FL 32940-6231
(321) 255-0025
(321) 255-0027
Mailing address
1705 BERGLUND LN, SUITE 103, VIERA, FL 32940-6231
(321) 255-0025
(321) 255-0027
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME85585
FL
208200000X
Plastic Surgery Physician
ME85585
FL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
ME85585
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
ME85585
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AH792
MEDICARE PTAN
FL
Enumeration date
01/07/2008
Last updated
07/17/2024
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