| Jamie Basak, RD/LDN | |
|
24829 Vintage Ct, Lutz, FL 33559-7401 | |
| (727) 342-3915 | |
| Not Available |
| Full Name | Jamie Basak |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 24829 Vintage Ct, Lutz, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619490430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | ND7286 (Florida) | Primary |
| Provider Name | Simplex Health |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1598137218 PECOS PAC ID: 8022354182 Enrollment ID: O20190110000206 |
| Mailing Address | Practice Location Address |
|---|---|
| Jamie Basak, RD/LDN 24829 Vintage Ct, Lutz, FL 33559-7401 Ph: (727) 342-3915 | Jamie Basak, RD/LDN 24829 Vintage Ct, Lutz, FL 33559-7401 Ph: (727) 342-3915 |
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