Individual
HEATHER DANIELLE BASAGOITIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMA, CPT
Contact information
Practice address
1345 SW 30TH ST, FORT LAUDERDALE, FL 33315-2842
(954) 629-4309
Mailing address
9715 W BROWARD BLVD # 233, PLANTATION, FL 33324-2351
(754) 227-9238
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
134047
FL
Other
Enumeration date
02/09/2020
Last updated
02/09/2020
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