Healthcare Provider Details

I. General information

NPI: 1639368673
Provider Name (Legal Business Name): AMIT DESAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 BEEHIVE CIR
SAINT CLOUD FL
34769-1432
US

IV. Provider business mailing address

91 BEEHIVE CIR
SAINT CLOUD FL
34769-1432
US

V. Phone/Fax

Practice location:
  • Phone: 321-805-5090
  • Fax:
Mailing address:
  • Phone: 321-805-5090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberP28788
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: