Healthcare Provider Details

I. General information

NPI: 1558957449
Provider Name (Legal Business Name): JINA DESAI PATEL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JINA DESAI

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 GALL BLVD
ZEPHYRHILLS FL
33541-4371
US

IV. Provider business mailing address

7400 GALL BLVD
ZEPHYRHILLS FL
33541-4371
US

V. Phone/Fax

Practice location:
  • Phone: 813-782-4546
  • Fax: 813-702-4054
Mailing address:
  • Phone: 813-782-4546
  • Fax: 813-702-4054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6846
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: