MEDICARE: RISING SUN RADIOLOGY, P.L.

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1780753228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISING SUN RADIOLOGY, P.L.

Provider Business Mailing Address
First Line	:	3264 WALTER TRAVIS DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-8644
Country	:	US
Telephone Number	:	941-323-0463
Fax Number	:	770-237-4950

Provider Business Practice Location Address
First Line	:	900 N ROBERTS AVE
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34266-8765
Country	:	US
Telephone Number	:	863-494-3535
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. UDAYAN AGRAWAL
Credential	:	M.D.
Telephone Number	:	727-896-3134

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	12/03/2007

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