Healthcare Provider Details

I. General information

NPI: 1821440314
Provider Name (Legal Business Name): MALIHA MAHMOOD DESMUKH M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W PALMETTO PARK RD STE 407
BOCA RATON FL
33433-3425
US

IV. Provider business mailing address

7000 W PALMETTO PARK RD STE 407
BOCA RATON FL
33433-3425
US

V. Phone/Fax

Practice location:
  • Phone: 954-227-2700
  • Fax: 954-227-2704
Mailing address:
  • Phone: 954-227-2700
  • Fax: 954-227-2704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number303682
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME156482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: