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Organization
KETAN TRIVEDI MD, PLLC
Active
Organization
KETAN TRIVEDI MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETAN TRIVEDI MD (MANAGING MEMBER)
(901) 734-9924
Entity
Organization
Contact information
Practice address
4760 TAMIAMI TRL N STE 24, NAPLES, FL 34103-3065
(239) 331-4870
(239) 315-4915
Mailing address
4422 CALDERA CIR, NAPLES, FL 34119-9057
(901) 734-9924
(239) 315-4915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME96812
MEDICAL LICENSE
FL
Enumeration date
06/14/2022
Last updated
06/14/2022
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