Provider Demographics
NPI:1780753228
Name:RISING SUN RADIOLOGY, P.L.
Entity type:Organization
Organization Name:RISING SUN RADIOLOGY, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:UDAYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-896-3134
Mailing Address - Street 1:3264 WALTER TRAVIS DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8644
Mailing Address - Country:US
Mailing Address - Phone:941-323-0463
Mailing Address - Fax:770-237-4950
Practice Address - Street 1:900 N ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-8765
Practice Address - Country:US
Practice Address - Phone:863-494-3535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF4193Medicare PIN
FLAA405Medicare PIN
H28327Medicare UPIN