Provider Demographics
NPI:1427057256
Name:DESAI, RAJESH KANTILAL (MD)
Entity type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:KANTILAL
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2290 W EAU GALLIE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3133
Mailing Address - Country:US
Mailing Address - Phone:321-309-9000
Mailing Address - Fax:321-309-9002
Practice Address - Street 1:2290 W EAU GALLIE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3133
Practice Address - Country:US
Practice Address - Phone:321-309-9000
Practice Address - Fax:321-309-9002
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME78676207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257527200Medicaid
FL257527200Medicaid
FL47107XMedicare PIN
FL47107ZMedicare PIN