Healthcare Provider Details

I. General information

NPI: 1386563716
Provider Name (Legal Business Name): TRUEFORM PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 E KENNEDY BLVD
TAMPA FL
33602-3517
US

IV. Provider business mailing address

1211 E KENNEDY BLVD UNIT 303
TAMPA FL
33602-3563
US

V. Phone/Fax

Practice location:
  • Phone: 813-252-0660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALISHA TRIVEDI
Title or Position: OWNER/PHYSICAL THERAPIST
Credential:
Phone: 813-252-0660