Healthcare Provider Details

I. General information

NPI: 1952838054
Provider Name (Legal Business Name): NIKHIL AGRAWAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E HIGHWAY 50 STE 202
CLERMONT FL
34711-1975
US

IV. Provider business mailing address

1919 E HIGHWAY 50 STE 202
CLERMONT FL
34711-1975
US

V. Phone/Fax

Practice location:
  • Phone: 352-432-9585
  • Fax:
Mailing address:
  • Phone: 352-432-9585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number316628
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME174835
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: