Organization
JESSE O BASADRE MD PA
Active
Other names
JESSE O BASADRE MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
MILLIE APONTE (OFFICE MANAGER)
(305) 857-5025
Entity
Organization
Contact information
Practice address
1699 SW 27TH AVE, MIAMI, FL 33145
(305) 857-5025
(305) 857-5024
Mailing address
1699 SW 27TH AVE, MIAMI, FL 33145-2074
(305) 857-5025
(305) 857-5024
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014909
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/25/2007
Last updated
09/07/2018
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