Provider Demographics
NPI:1578887477
Name:BASI, JOSEPH ROCCO (ARNP)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROCCO
Last Name:BASI
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-3660
Mailing Address - Fax:239-343-4133
Practice Address - Street 1:708 DEL PRADO BLVD S STE 7
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2676
Practice Address - Country:US
Practice Address - Phone:239-424-3660
Practice Address - Fax:239-343-4133
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3154412363L00000X
FLAPRN3154412363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY03WBOtherBCBS ATTACHED TO GROUP 40793
FL110469700Medicaid
FLY03WBOtherBCBS ATTACHED TO GROUP 40793