Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME55851 | FL |
NPI | 1124047428 |
---|---|
Provider Name | Dr. Akshay M. Desai |
First Address | St Petersburg, FL 33709-2150 |
Second Address | St Petersburg, FL 33709-2148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 12/10/2015 |