Provider Demographics
NPI:1255772133
Name:JASSI, DEEMA (MD)
Entity type:Individual
Prefix:DR
First Name:DEEMA
Middle Name:
Last Name:JASSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NW 9TH AVE
Mailing Address - Street 2:470
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1101
Mailing Address - Country:US
Mailing Address - Phone:786-466-4083
Mailing Address - Fax:
Practice Address - Street 1:1801 NW 9TH AVE
Practice Address - Street 2:470
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1101
Practice Address - Country:US
Practice Address - Phone:786-466-4083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-18709207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine