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General NPI Number Information
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NPI Number | 1588960900
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Entity Type | Individual
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Provider Name | MALA PRAKASH TRIVEDI M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 1 TAMPA GENERAL CIR
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City | TAMPA
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State | FL
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Zip | 33606-3571
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Country | US
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Telephone | 813-844-7551
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Fax | 813-844-4345
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Provider Business Mailing Address
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Address Line | 3400 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4238
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Country | US
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Telephone | 215-662-6698
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME148861
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License Number State | FL
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