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NPI Code Detail

MEDICARE: KETAN HASMUKHRAI TRIVEDI M.D.

MEDICARE:   KETAN HASMUKHRAI TRIVEDI  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME 96812FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
168351OTHERFLFL BLUE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588747885
Entity Type Code : Individual
Provider Name (Legal Business Name) : KETAN HASMUKHRAI TRIVEDI M.D.
Provider Business Mailing Address
First Line : 4513 EXECUTIVE DR STE 201
Second Line :
City : NAPLES
State : FL
Zip : 34119-9033
Country : US
Telephone Number : 239-624-8130
Fax Number : 239-624-0831
Provider Business Practice Location Address
First Line : 4513 EXECUTIVE DR STE 201
Second Line :
City : NAPLES
State : FL
Zip : 34119-9033
Country : US
Telephone Number : 239-624-8130
Fax Number : 239-624-0831
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 03/13/2024

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Directions to “ KETAN HASMUKHRAI TRIVEDI M.D.” Practice Location

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