Provider Demographics
NPI:1487612693
Name:DESAI, UDAYKUMAR J (BPHARM)
Entity type:Individual
Prefix:MR
First Name:UDAYKUMAR
Middle Name:J
Last Name:DESAI
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 AUTUMN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7425
Mailing Address - Country:US
Mailing Address - Phone:407-482-0785
Mailing Address - Fax:
Practice Address - Street 1:40230 US HIGHWAY 27 N
Practice Address - Street 2:100-110
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-2636
Practice Address - Country:US
Practice Address - Phone:855-633-6948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35584183500000X
NY050712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist