Healthcare Provider Details

I. General information

NPI: 1780753228
Provider Name (Legal Business Name): RISING SUN RADIOLOGY, P.L.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N ROBERTS AVE
ARCADIA FL
34266-8765
US

IV. Provider business mailing address

3264 WALTER TRAVIS DR
SARASOTA FL
34240-8644
US

V. Phone/Fax

Practice location:
  • Phone: 863-494-3535
  • Fax:
Mailing address:
  • Phone: 941-323-0463
  • Fax: 770-237-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. UDAYAN AGRAWAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-896-3134