Provider Demographics
NPI:1164734620
Name:AGARWAL, ANJU (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJU
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 CENTENNIAL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0606
Mailing Address - Country:US
Mailing Address - Phone:850-431-5404
Mailing Address - Fax:850-656-3376
Practice Address - Street 1:2633 CENTENNIAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0606
Practice Address - Country:US
Practice Address - Phone:850-431-5404
Practice Address - Fax:850-656-3376
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME149023207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism