Provider Demographics
NPI:1811094980
Name:AGGARWAL, DARSHAN C (MD)
Entity type:Individual
Prefix:DR
First Name:DARSHAN
Middle Name:C
Last Name:AGGARWAL
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:PO BOX 15129
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34979-5129
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038306174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL56112Medicare ID - Type UnspecifiedNEUROLOGIST
FLD65148Medicare UPIN