Provider Demographics
NPI:1689388183
Name:DESAI, SALIL (DPM)
Entity Type:Individual
Prefix:DR
First Name:SALIL
Middle Name:
Last Name:DESAI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6702 THACKSTON DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-1321
Mailing Address - Country:US
Mailing Address - Phone:813-465-1620
Mailing Address - Fax:
Practice Address - Street 1:6326 FORT KING RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2531
Practice Address - Country:US
Practice Address - Phone:813-788-3600
Practice Address - Fax:813-788-7010
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4461213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery