MEDICARE: DR. MIT NAVANIT DESAI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME 87408	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407822422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIT NAVANIT DESAI MD

Provider Business Mailing Address
First Line	:	PO BOX 21647
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33622-1647
Country	:	US
Telephone Number	:	813-530-5043
Fax Number	:	813-530-5043

Provider Business Practice Location Address
First Line	:	17222 HOSPITAL BLVD STE 116
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34601-8925
Country	:	US
Telephone Number	:	813-751-0427
Fax Number	:	813-948-0000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	04/10/2020

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