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General NPI Number Information
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NPI Number | 1184906810
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Entity Type | Organization
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Legal Business Name | SHEKHAR DESAI MD LLC
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 311 LANSING ISLAND DR
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City | SATELLITE BEACH
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State | FL
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Zip | 32937-5106
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Country | US
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Telephone | 321-543-5203
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Fax | 321-777-2235
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Provider Business Mailing Address
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Address Line | PO BOX 372913
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City | SATELLITE BEACH
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State | FL
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Zip | 32937-0913
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Country | US
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Telephone | 321-543-5203
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Fax | 321-777-2235
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHEKHAR DESAI
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Credential | M.D.
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Telephone | 321-543-5203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME59178
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License Number State | FL
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