Provider Demographics
NPI:1699303107
Name:GIUNTI BASSO, RAFAELA (MD)
Entity type:Individual
Prefix:
First Name:RAFAELA
Middle Name:
Last Name:GIUNTI BASSO
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 1:2151 CONSULATE DR STE 17
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8808
Mailing Address - Country:US
Mailing Address - Phone:407-630-6630
Mailing Address - Fax:407-512-5116
Practice Address - Street 1:2151 CONSULATE DR STE 17
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8808
Practice Address - Country:US
Practice Address - Phone:407-630-6630
Practice Address - Fax:407-512-5116
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME161256207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine