Provider Demographics
NPI:1558363572
Name:DESAI, MARIA JULIA JOCELYN (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JULIA JOCELYN
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:JULIA JOCELYN
Other - Last Name:PINTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 25595
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5595
Mailing Address - Country:US
Mailing Address - Phone:727-823-2188
Mailing Address - Fax:727-828-0723
Practice Address - Street 1:7171 N DALE MABRY HWY
Practice Address - Street 2:STE 404
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2665
Practice Address - Country:US
Practice Address - Phone:813-558-4900
Practice Address - Fax:813-558-2155
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME877572083P0011X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL323296OtherAVMED
FL48363OtherBCBS
FLP00863034OtherRAILROAD MCR TO GRP# DQ1103
FL275398700Medicaid
H49604Medicare UPIN
FL323296OtherAVMED
FL275398700Medicaid