MEDICARE: DR. PRATIBHA KIRIT DESAI MD

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	174400000X	Specialist	ME66436	FL
2	207RH0003X	Hematology & Oncology Physician	ME66436	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P02205624	OTHER	FL	RAILROAD MEDICARE

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
2	26693	OTHER	FL	BCBS FL

General Provider Information

NPI Number	:	1861488454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRATIBHA KIRIT DESAI MD

Provider Business Mailing Address
First Line	:	5000 PARK ST N
Second Line	:	STE 1017
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33709-2236
Country	:	US
Telephone Number	:	727-344-6570
Fax Number	:	727-384-4388

Provider Business Practice Location Address
First Line	:	5000 PARK ST N STE 1017
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33709-2236
Country	:	US
Telephone Number	:	727-344-6569
Fax Number	:	727-384-4388

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	08/27/2020

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Directions to “ DR. PRATIBHA KIRIT DESAI MD” Practice Location

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