Doctor Name: | DR. UTPAL S DESAI |
NPI Number: | 1760478101 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME82884 |
Business Practice Address: | 305 Memorial Medical Pkwy Ste 307 Daytona Beach, FL - 321175169 |
Business Phone Number: | 3862313600 |
Business Fax Number: | 3862313602 |
Mailing Address: | Po Box 864627, ORLANDO |
State: | FL |
Postal Code: | 328864627 |
Phone Number: | 3862313600 |
Fax Number: | 3862313602 |
NPI Enumeration Date: | 09/21/2005 |
NPI Last Update Date: | 03/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME82884 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |