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Individual

PRASHANT M DESAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
789 DOUGLAS AVE STE 137, ALTAMONTE SPRINGS, FL 32714-2573
(407) 862-9988
(407) 862-1283
Mailing address
789 DOUGLAS AVE STE 137, ALTAMONTE SPRINGS, FL 32714-2573
(407) 862-9988
(407) 862-1283

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0059526
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14489
BLUE CROSS BLUE SHIELD
FL
01
233386
AMERIGROUP
FL
01
4259760
AETNA
FL
Enumeration date
08/07/2006
Last updated
07/08/2007
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