Provider Demographics
NPI:1972539237
Name:AGARWAL, ANURAG (MD)
Entity Type:Individual
Prefix:DR
First Name:ANURAG
Middle Name:
Last Name:AGARWAL
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 1:1175 CREEKSIDE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-2068
Mailing Address - Country:US
Mailing Address - Phone:239-594-9100
Mailing Address - Fax:239-594-3054
Practice Address - Street 1:1175 CREEKSIDE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-2068
Practice Address - Country:US
Practice Address - Phone:239-594-9100
Practice Address - Fax:239-594-3054
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91699207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28676ZMedicare PIN
FLI40120Medicare UPIN