Healthcare Provider Details

I. General information

NPI: 1265274195
Provider Name (Legal Business Name): DAYA DESAI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER ROAD
GAINESVILLE FL
32610-3001
US

IV. Provider business mailing address

PO BOX 100279
GAINESVILLE FL
32610-0279
US

V. Phone/Fax

Practice location:
  • Phone: 352-594-1942
  • Fax:
Mailing address:
  • Phone: 352-594-1942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119124
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: