# MINDBODY INTEGRATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225340789
- **Authorized official:** MAULIK TRIVEDI M.D. (PRESIDENT)
- **Authorized official phone:** (813) 650-3239

## Contact information

- **Practice address:** 2204 S PARSONS AVE, SEFFNER, FL 33584-5212
- **Practice address phone:** (813) 684-3222
- **Practice address fax:** (813) 464-2787
- **Mailing address:** 809 E BLOOMINGDALE AVE, PMB \# 377, BRANDON, FL 33511-8113
- **Mailing address phone:** (813) 650-3239
- **Mailing address fax:** (813) 464-2787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | ME 84208 | FL | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | ME 84208 | FL | Yes |

## Other

- **Enumeration date:** 07/12/2010
- **Last updated:** 09/22/2010