Provider Demographics
NPI:1760708085
Name:SHIV AGGARWAL MD PA
Entity Type:Organization
Organization Name:SHIV AGGARWAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHIV
Authorized Official - Middle Name:K
Authorized Official - Last Name:AGGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-842-7088
Mailing Address - Street 1:5522 TROUBLE CREEK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-5171
Mailing Address - Country:US
Mailing Address - Phone:727-842-7088
Mailing Address - Fax:727-848-6731
Practice Address - Street 1:5522 TROUBLE CREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-5171
Practice Address - Country:US
Practice Address - Phone:727-842-7088
Practice Address - Fax:727-848-6731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty