Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME 129087 | FL |
Y | 111NI0900X | Internist | ME 129087 | FL |
NPI | 1003256736 |
---|---|
Provider Name | Dr. Chirayu Trivedi |
First Address | Weston, FL 33331-3609 |
Second Address | Weston, FL 33331-3502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 02/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ME 129087 | FLORIDA MEDICAL LICENSE NUMBER (01) | FL |