Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | ME96679 | FL |
NPI | 1043223308 |
---|---|
Provider Name | Dr. Rohan K Desai |
First Address | Orange City, FL 32763-8396 |
Second Address | Orange City, FL 32763-8396 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 19/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
280213900 | (05) | FL |
AD787Y | MEDICARE PTAN (01) | FL |