Individual
DR. THEODORE A BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP CARDIOLOGY, JACKSONVILLE, FL 32209
(904) 244-2655
(904) 244-5913
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME40457
FL
207RC0000X
Cardiovascular Disease Physician
ME40457
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME40457
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000248366B
—
GA
05
—
0670464-00
—
FL
Enumeration date
02/23/2006
Last updated
06/12/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us