Provider Demographics
NPI:1205150661
Name:DESANETO, ARTUR (MD)
Entity type:Individual
Prefix:DR
First Name:ARTUR
Middle Name:
Last Name:DESANETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6383
Mailing Address - Country:US
Mailing Address - Phone:813-873-0000
Mailing Address - Fax:813-873-3659
Practice Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 800
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6383
Practice Address - Country:US
Practice Address - Phone:813-873-0000
Practice Address - Fax:813-873-3659
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11865207RC0000X
FLME122693207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
1205150661OtherNPI
12118127OtherCAQH
1205150661OtherNPI