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General NPI Number Information
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NPI Number | 1447605704
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Entity Type | Individual
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Provider Name | ABHIMANYU AGGARWAL MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2016
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 800 PRUDENTIAL DR FL 8202
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8202
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Country | US
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Telephone | 703-732-5623
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Fax |
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Provider Business Mailing Address
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Address Line | 4451 LOGMILL RD
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City | GAINESVILLE
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State | VA
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Zip | 20155-1046
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 68697
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME166355
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD474970
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D0096589
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License Number State | MD
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