Provider Demographics
NPI:1013035146
Name:AMERICAN FAMILY & GERIATRIC CARE PA
Entity Type:Organization
Organization Name:AMERICAN FAMILY & GERIATRIC CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AKSHAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-527-8788
Mailing Address - Street 1:5880 49TH ST N
Mailing Address - Street 2:SUITE 101 N
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2150
Mailing Address - Country:US
Mailing Address - Phone:727-527-8788
Mailing Address - Fax:727-527-8828
Practice Address - Street 1:5880 49TH ST N
Practice Address - Street 2:SUITE 101 N
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2150
Practice Address - Country:US
Practice Address - Phone:727-527-8788
Practice Address - Fax:727-527-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40899FMedicare PIN