Individual
SMITA V DESHPANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 GLADES RD # SS 8W240, BOCA RATON, FL 33431-6424
(610) 969-3390
(610) 969-3393
Mailing address
777 GLADES RD # SS 8W240, BOCA RATON, FL 33431-6496
(561) 297-3512
(561) 297-0494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD039267L
PA
207Q00000X
Family Medicine Physician
ME158311
FL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MD039267L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014630700004
—
PA
01
—
0050865000
IBC
—
01
—
03161201
CBC
—
01
—
464569
HIGHMARK BLUE SHIELD
—
01
—
P002820
GATEWAY
—
Enumeration date
10/24/2005
Last updated
11/08/2023
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