Individual
DR. MARY ELLEN BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3949 EVANS AVE, FORT MYERS, FL 33901-9335
(239) 939-2622
(239) 939-0151
Mailing address
3949 EVANS AVE, FORT MYERS, FL 33901-9335
(239) 939-2622
(239) 939-2622
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
219917
NY
207L00000X
Anesthesiology Physician
Primary
ME111083
FL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
219917
NY
Other
Enumeration date
01/24/2007
Last updated
12/17/2019
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