Provider Demographics
NPI:1750358990
Name:GARG, ANIT (MD)
Entity type:Individual
Prefix:DR
First Name:ANIT
Middle Name:
Last Name:GARG
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 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:8787 BRYAN DAIRY RD STE 275
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777
Practice Address - Country:US
Practice Address - Phone:727-394-5560
Practice Address - Fax:727-635-7939
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272683100Medicaid
FL272683100Medicaid
FLK5346Medicare ID - Type Unspecified
FL37657WMedicare PIN