Provider Demographics
NPI:1770845059
Name:TRIVEDI, NIDHI A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:NIDHI
Middle Name:A
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 RINEHART RD
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2514
Mailing Address - Country:US
Mailing Address - Phone:321-843-2100
Mailing Address - Fax:321-842-3498
Practice Address - Street 1:210 RINEHART RD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2514
Practice Address - Country:US
Practice Address - Phone:321-843-2100
Practice Address - Fax:321-842-3498
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337323363LF0000X
FLAPRN9484219363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily