Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME125038 | FL |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD468246 | PA |
NPI | 1013270628 |
---|---|
Provider Name | Dr. Kavita Ajitkumar Desai |
First Address | Miami, FL 33155 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 29/01/2020 |