Healthcare Provider Details

I. General information

NPI: 1477643856
Provider Name (Legal Business Name): DARSHAN GHANSHYAMBHAI TRIVEDI M.D.F.A.A.P
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 STATE ROAD 54 STE 108
TRINITY FL
34655-2263
US

IV. Provider business mailing address

10710 STATE ROAD 54 STE 108
TRINITY FL
34655-2263
US

V. Phone/Fax

Practice location:
  • Phone: 727-376-4040
  • Fax: 727-376-8824
Mailing address:
  • Phone: 727-376-4040
  • Fax: 845-333-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125080
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: