Healthcare Provider Details

I. General information

NPI: 1396974697
Provider Name (Legal Business Name): PREEYA DESH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 GREENWOOD AVE SUITE 306
WEST PALM BEACH FL
33407-2452
US

IV. Provider business mailing address

5325 GREENWOOD AVE SUITE 306
WEST PALM BEACH FL
33407-2452
US

V. Phone/Fax

Practice location:
  • Phone: 561-844-6363
  • Fax: 561-844-6391
Mailing address:
  • Phone: 561-844-6363
  • Fax: 561-844-6391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME115072
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberLP01781
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License NumberME115072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: