Provider Demographics
NPI:1750873444
Name:BASSETT, MARCELE T SR
Entity type:Individual
Prefix:MR
First Name:MARCELE
Middle Name:T
Last Name:BASSETT
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14609 WHITE JADE TER
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2231
Mailing Address - Country:US
Mailing Address - Phone:561-501-7837
Mailing Address - Fax:
Practice Address - Street 1:14609 WHITE JADE TER
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2231
Practice Address - Country:US
Practice Address - Phone:561-501-7837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906916311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home