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NPI Code Detail

MEDICARE: MANATEE GYNECOLOGY LLC

MEDICARE: MANATEE GYNECOLOGY LLC
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
1207VG0400XGynecology Physician

General Provider Information

NPI Number : 1578077970
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANATEE GYNECOLOGY LLC
Provider Business Mailing Address
First Line : 2310 60TH STREET CT W
Second Line :
City : BRADENTON
State : FL
Zip : 34209-6609
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2310 60TH STREET CT W
Second Line :
City : BRADENTON
State : FL
Zip : 34209-6609
Country : US
Telephone Number : 941-792-4993
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KINNARI DESAI
Credential : MD
Telephone Number : 941-792-4993
Provider Enumeration Date : 11/21/2017
Last Update Date : 12/07/2017

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Directions to “MANATEE GYNECOLOGY LLC ” Practice Location

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