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General NPI Number Information
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NPI Number | 1558464248
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Entity Type | Organization
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Legal Business Name | USHA AGARWAL MD PA
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 3543 LITTLE RD STE B
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City | TRINITY
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State | FL
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Zip | 34655-1811
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Country | US
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Telephone | 727-846-9419
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Fax | 727-848-6200
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Provider Business Mailing Address
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Address Line | PO BOX 1945
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City | PALM HARBOR
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State | FL
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Zip | 34682-1945
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Country | US
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Telephone | 727-846-9419
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Fax | 727-848-6200
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Authorized Official
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Title or Position | OWNER PROVIDER
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Name | USHA AGARWAL
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Credential | MD
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Telephone | 727-846-9419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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