Theodotou, Basil

Theodotou, Basil is an individual health care provider with primary practice located at 32 Suntree Pl , Melbourne FL 32940-7689. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Theodotou, Basil can be contacted via phone (321) 752-7001.

Contact Information

Primary practice address
32 Suntree Pl Melbourne FL 32940-7689
Fax: (321) 254-1776
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X ME0046303 Florida

Profile Details

NPI number 1760487961
LBN Legal business name Theodotou, Basil
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Dec 6th, 2011 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760487961 NPPES
Florida MEDICAID 041713100

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