Healthcare Provider Details

I. General information

NPI: 1316981368
Provider Name (Legal Business Name): SANDRA P DESAI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 DEL PRADO BLVD S
CAPE CORAL FL
33990-1710
US

IV. Provider business mailing address

PO BOX 1588
FORT MYERS FL
33902-1588
US

V. Phone/Fax

Practice location:
  • Phone: 239-738-7324
  • Fax: 239-458-2009
Mailing address:
  • Phone: 239-936-2454
  • Fax: 239-936-1974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO2833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: