Provider Demographics
NPI:1740527282
Name:DARSHAN AGGARWAL MD PA
Entity type:Organization
Organization Name:DARSHAN AGGARWAL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-489-6300
Mailing Address - Street 1:2215 NEBRASKA AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4864
Mailing Address - Country:US
Mailing Address - Phone:772-489-6300
Mailing Address - Fax:772-464-4421
Practice Address - Street 1:2215 NEBRASKA AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4864
Practice Address - Country:US
Practice Address - Phone:772-489-6300
Practice Address - Fax:772-464-4421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038306174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000724300Medicaid
FL000724300Medicaid
FL56112Medicare PIN