Provider Demographics
NPI:1205036647
Name:AGGARWAL, PREYANKA (MD)
Entity Type:Individual
Prefix:DR
First Name:PREYANKA
Middle Name:
Last Name:AGGARWAL
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 1:36245 HWY 27
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-3744
Mailing Address - Country:US
Mailing Address - Phone:863-421-9801
Mailing Address - Fax:863-229-7513
Practice Address - Street 1:36245 HWY 27
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-3744
Practice Address - Country:US
Practice Address - Phone:863-421-9801
Practice Address - Fax:863-421-9364
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441217207Q00000X
FLME130157207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30083811OtherAMERIHEALTH MERCY-WMG
FL019381500Medicaid
PA2525182OtherHIGHMARK BLUE SHIELD-WMG
PA415979OtherUPMC-WMG
PA102516402Medicaid
PAP009192OtherGATEWAY-WMG
PA395282OtherUNISON-WMG
PA970367OtherCAREFIRST MD BCBS
PA30083811OtherAMERIHEALTH MERCY-WMG
PA970367OtherCAREFIRST MD BCBS