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NPI Code Detail

MEDICARE: DR. DEVYANI N DESAI MD

MEDICARE: DR. DEVYANI N 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
12084P0800XPsychiatry Physician4301047811MI
22084P0800XPsychiatry PhysicianME54873FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
214238OTHERFLBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558354175
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEVYANI N DESAI MD
Provider Business Mailing Address
First Line : 320 DEBUEL RD
Second Line :
City : LUTZ
State : FL
Zip : 33549-5444
Country : US
Telephone Number : 813-404-7980
Fax Number : 863-413-3083
Provider Business Practice Location Address
First Line : 1835 GILMORE AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3017
Country : US
Telephone Number : 863-248-3300
Fax Number : 863-413-3083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 05/20/2016

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Directions to “ DR. DEVYANI N DESAI MD” Practice Location

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