MEDICARE: PRASHANT J DESAI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	OS9090	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720050925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRASHANT J DESAI DO

Provider Business Mailing Address
First Line	:	1600 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-3019
Country	:	US
Telephone Number	:	863-680-7830
Fax Number	:	866-264-8519

Provider Business Practice Location Address
First Line	:	2300 E COUNTY ROAD 540A
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3825
Country	:	US
Telephone Number	:	863-680-7214
Fax Number	:	866-264-8519

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	11/27/2023

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Directions to “ PRASHANT J DESAI DO” Practice Location

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