Provider Demographics
NPI:1477513802
Name:AGGARWAL, MONICA (MD)
Entity type:Individual
Prefix:
First Name:MONICA
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 1:1925 MIZELL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4155
Mailing Address - Country:US
Mailing Address - Phone:407-894-4474
Mailing Address - Fax:
Practice Address - Street 1:1925 MIZELL AVE STE 100
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4155
Practice Address - Country:US
Practice Address - Phone:407-894-4474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME129783207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00475057OtherRR MEDICARE
FL019120200Medicaid
FL019120200Medicaid
MD930LS074Medicare PIN
MDP00475057OtherRR MEDICARE
FLIT954ZMedicare PIN