Bass, Theodore A
Bass, Theodore A is an individual health care provider with primary practice located at 655 W 8Th St Ufjp Cardiology, Jacksonville FL 32209. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Bass, Theodore A can be contacted via phone (904) 244-2655.Contact Information
Primary practice address
655 W 8Th St Ufjp Cardiology
Jacksonville FL 32209
Phone: (904) 244-2655
Fax: (904) 244-5913
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME40457 | Florida |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | ME40457 | Florida |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | ME40457 | Florida |
Profile Details
| NPI number | 1902872740 |
|---|---|
| LBN Legal business name | Bass, Theodore A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2006 |
| Last updated | Jun 12th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902872740 | NPPES |
| Florida | MEDICAID | 0670464-00 | |
| Florida | MEDICAID | 000248366B |
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