MEDICARE: BANKE AGARWAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	ME179089	FL
2	207RG0100X	Gastroenterology Physician	2002001059	MO
3	207RG0100X	Gastroenterology Physician	74648	WI

General Provider Information

NPI Number	:	1134137011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BANKE AGARWAL MD

Provider Business Mailing Address
First Line	:	1324 LAKELAND HILLS BLVD
Second Line	:	ATTN: MANAGED CARE
City	:	LAKELAND
State	:	FL
Zip	:	33805-4543
Country	:	US
Telephone Number	:	863-687-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4120 US HIGHWAY 98 N
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-3854
Country	:	US
Telephone Number	:	863-687-8335
Fax Number	:	863-687-8337

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	04/24/2026

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