Provider Demographics
NPI:1144495383
Name:TRIVEDI, BHAVYA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:BHAVYA
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 MARLEON DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-7020
Mailing Address - Country:US
Mailing Address - Phone:407-588-0550
Mailing Address - Fax:473-315-9411
Practice Address - Street 1:6735 CONROY RD STE 414
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3567
Practice Address - Country:US
Practice Address - Phone:407-588-0550
Practice Address - Fax:407-315-9411
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1043102080P0202X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01722493Medicaid