| Ketan Trivedi Md, Pllc | |
|
4760 Tamiami Trl N Ste 24 Naples FL 34103-3065 | |
| (239) 331-4870 | |
| (239) 315-4915 |
| Full Name | Ketan Trivedi Md, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4760 Tamiami Trl N Ste 24, Naples, Florida |
| Authorized Official Name and Position | Ketan Trivedi (MANAGING MEMBER) |
| Authorized Official Contact | 9017349924 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketan Trivedi Md, Pllc 4422 Caldera Cir Naples FL 34119-9057 Ph: (901) 734-9924 | Ketan Trivedi Md, Pllc 4760 Tamiami Trl N Ste 24 Naples FL 34103-3065 Ph: (239) 331-4870 |
| NPI Number | 1598495376 |
|---|---|
| Provider Enumeration Date | 06/14/2022 |
| Last Update Date | 06/14/2022 |
| Medicare PECOS PAC ID | 2466834148 |
|---|---|
| Medicare Enrollment ID | O20220727002188 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598495376 | NPI | - | NPPES |
| ME96812 | Other | FL | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ketan Hasmukhrai Trivedi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588747885 PECOS PAC ID: 1951402585 Enrollment ID: I20070725000701 |
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