Provider Demographics
NPI:1255569554
Name:DESAI, NILESH (MD)
Entity type:Individual
Prefix:DR
First Name:NILESH
Middle Name:
Last Name:DESAI
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 1:5234 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1213
Mailing Address - Country:US
Mailing Address - Phone:727-807-6900
Mailing Address - Fax:727-807-6901
Practice Address - Street 1:5234 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1213
Practice Address - Country:US
Practice Address - Phone:727-807-6900
Practice Address - Fax:727-807-6901
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine