MEDICARE: RAJESH AGRAWAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	ME68290	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	110200401	OTHER	FL	MEDICARE RAILROAD INDIVIDUAL
6	CH2504	OTHER	FL	MEDICARE RAILROAD GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1467464990	OTHER	FL	GROUP NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	6000/211534	OTHER		AVMED PROVIDER NUMBERS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295712602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJESH AGRAWAL MD

Provider Business Mailing Address
First Line	:	6223 66TH STREET NORTH
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-5025
Country	:	US
Telephone Number	:	727-528-4900
Fax Number	:	727-528-8628

Provider Business Practice Location Address
First Line	:	6223 66TH STREET NORTH
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-5025
Country	:	US
Telephone Number	:	727-528-4900
Fax Number	:	727-528-8628

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	09/09/2014

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Directions to “ RAJESH AGRAWAL MD” Practice Location

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