Provider Demographics
NPI:1619922838
Name:DESAI, MEHUL BHALCHANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHUL
Middle Name:BHALCHANDRA
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:8100 SW 10TH ST
Mailing Address - Street 2:CROSS ROAD BUISNESS PARK BLD 3, SUITE 1700J
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3279
Mailing Address - Country:US
Mailing Address - Phone:954-210-1155
Mailing Address - Fax:954-753-8321
Practice Address - Street 1:8100 SW 10TH ST
Practice Address - Street 2:CROSS ROAD BUISNESS PARK BLD 3, SUITE 1700J
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3279
Practice Address - Country:US
Practice Address - Phone:954-210-1155
Practice Address - Fax:954-753-8321
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME633932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF54674Medicare UPIN
FL25549Medicare ID - Type Unspecified