| Telepsychhealth | |
|
12058 San Jose Blvd Ste 202 Jacksonville FL 32223-8669 | |
| (888) 730-5220 | |
| (888) 524-8166 |
| Full Name | Telepsychhealth |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12058 San Jose Blvd Ste 202, Jacksonville, Florida |
| Authorized Official Name and Position | Bruce Daniel Bassi (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8887305220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telepsychhealth 12058 San Jose Blvd Ste 202 Jacksonville FL 32223-8669 Ph: (888) 730-5220 | Telepsychhealth 12058 San Jose Blvd Ste 202 Jacksonville FL 32223-8669 Ph: (888) 730-5220 |
| NPI Number | 1013425586 |
|---|---|
| Provider Enumeration Date | 01/17/2018 |
| Last Update Date | 04/15/2022 |
| Certification Date | 04/15/2022 |
| Medicare PECOS PAC ID | 9931439031 |
|---|---|
| Medicare Enrollment ID | O20191002001341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013425586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME129546 (Florida) | Primary |
| Provider Name | Bruce Daniel Bassi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093125759 PECOS PAC ID: 0042515140 Enrollment ID: I20191003003035 |
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