Individual
AMI NIRAV DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5811 E BROADWAY AVE, TAMPA, FL 33619-2813
(813) 791-7092
Mailing address
5811 E BROADWAY AVE, TAMPA, FL 33619-2813
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN26012
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/20/2021
Last updated
03/16/2023
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