Provider Demographics
NPI:1982675526
Name:DESAI, CHETAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:CHETAN
Middle Name:K
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3001 EXECUTIVE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5323
Mailing Address - Country:US
Mailing Address - Phone:727-347-0005
Mailing Address - Fax:727-541-6558
Practice Address - Street 1:3901 66TH ST N
Practice Address - Street 2:SUITE 201
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-4911
Practice Address - Country:US
Practice Address - Phone:727-345-5500
Practice Address - Fax:727-345-6164
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME59176207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
211863OtherAV MED
231448OtherAMERIGROUP
2905012OtherUNITED HEALTHCARE
SN13000OtherCAREPLUS
100013672OtherRAILROAD MEDICARE
10694901OtherCITRUS HEALTHCARE
FL370551000Medicaid
01532OtherWELLCARE
14960OtherBCBS
2452114-018OtherCIGNA
2510731OtherGHI
4349248OtherAETNA
852OtherUNIVERSAL HEALTHCARE