Healthcare Provider Details
I. General information
NPI: 1144215138
Provider Name (Legal Business Name): SUDHIR AGARWAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/15/2005
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3543 LITTLE RD STE A
TRINITY FL
34655-1814
US
IV. Provider business mailing address
2410 NORTHSIDE DR STE A
CLEARWATER FL
33761-2236
US
V. Phone/Fax
- Phone: 727-848-6400
- Fax: 727-848-6200
- Phone: 727-499-0351
- Fax: 727-223-4159
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | ME64377 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: