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General NPI Number Information
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NPI Number | 1881831576
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Entity Type | Organization
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Legal Business Name | DESAI MEDICAL CENTER FOR PRIMARY CARE AND INTEGRATIVE MEDICINE PA
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 773 COUNTY ROAD 466 THE SUMMIT OF LADY LAKE
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City | LADY LAKE
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State | FL
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Zip | 32159-6340
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Country | US
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Telephone | 321-274-1864
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Fax | 352-259-1132
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Provider Business Mailing Address
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Address Line | 773 CR 466 THE SUMMIT OF LADY LAKE
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City | LADY LAKE
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State | FL
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Zip | 32159-6340
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Country | US
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Telephone | 321-274-1864
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Fax | 352-259-1132
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Authorized Official
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Title or Position | OWNER
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Name | DR. KALPANA P DESAI
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Credential | M.D.
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Telephone | 321-274-1864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME92848
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License Number State | FL
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