MEDICARE: SNEHAL 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	207RG0100X	Gastroenterology Physician	ME151567	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	:	1659472611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SNEHAL DESAI MD

Provider Business Mailing Address
First Line	:	4800 BELFORT RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6004
Country	:	US
Telephone Number	:	850-390-4540
Fax Number	:	850-390-4540

Provider Business Practice Location Address
First Line	:	23 MACK BAYOU LOOP
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-2606
Country	:	US
Telephone Number	:	850-390-4540
Fax Number	:	850-390-4540

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	04/19/2022

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Directions to “ SNEHAL DESAI MD” Practice Location

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