MEDICARE: DR. MALIHA MAHMOOD DESMUKH M.D

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	2084P0800X	Psychiatry Physician	303682	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084P0800X	Psychiatry Physician	ME156482	FL

General Provider Information

NPI Number	:	1821440314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALIHA MAHMOOD DESMUKH M.D

Provider Business Mailing Address
First Line	:	7000 W PALMETTO PARK RD STE 407
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3425
Country	:	US
Telephone Number	:	954-227-2700
Fax Number	:	954-227-2704

Provider Business Practice Location Address
First Line	:	7000 W PALMETTO PARK RD STE 407
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3425
Country	:	US
Telephone Number	:	954-227-2700
Fax Number	:	954-227-2704

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

Provider Enumeration Date	:	07/07/2016
Last Update Date	:	06/30/2022

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