Provider Demographics
NPI:1083760516
Name:BASSETTE, ROSS LYMAN (RN)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:LYMAN
Last Name:BASSETTE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4311 DUNMORE AVE
Mailing Address - Street 2:APT 8
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5722
Mailing Address - Country:US
Mailing Address - Phone:813-362-3683
Mailing Address - Fax:
Practice Address - Street 1:4311 DUNMORE AVE
Practice Address - Street 2:APT 8
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-5722
Practice Address - Country:US
Practice Address - Phone:813-362-3683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9235682163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse