Provider Demographics
NPI:1093453920
Name:DESAI, JIGNESH KISHORSINH (DPM)
Entity type:Individual
Prefix:
First Name:JIGNESH
Middle Name:KISHORSINH
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 1:7421 N UNIVERSITY DR STE 304
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2953
Mailing Address - Country:US
Mailing Address - Phone:954-722-8080
Mailing Address - Fax:
Practice Address - Street 1:7421 N UNIVERSITY DR STE 304
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2953
Practice Address - Country:US
Practice Address - Phone:954-722-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLPO4556213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program