Provider Demographics
NPI:1417920901
Name:AGRIOS, ANTHONY B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:B
Last Name:AGRIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 W NEWBERRY RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4381
Mailing Address - Country:US
Mailing Address - Phone:352-331-3332
Mailing Address - Fax:352-331-3320
Practice Address - Street 1:6440 W NEWBERRY RD
Practice Address - Street 2:SUITE 111
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4381
Practice Address - Country:US
Practice Address - Phone:352-331-3332
Practice Address - Fax:352-331-3320
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL67571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG68852Medicare UPIN
FL31735Medicare ID - Type Unspecified