Individual
DR. BASSEM M ELDAIF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6032 FARCENDA PL STE 102, MELBOURNE, FL 32940
(321) 215-4799
(321) 252-4855
Mailing address
2085 HIGHWAY A1A APT 3301, INDIAN HARBOUR BEACH, FL 32937-1804
(954) 294-1963
(866) 683-6309
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME101077
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000314200
—
FL
01
—
ME101077
FLORIDA MEDICAL LICENSE
FL
Enumeration date
04/28/2008
Last updated
07/29/2018
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