Individual provider · NPI-1

Dr. Bansidas M Agravat, M.D

Emergency Medicine · Tallahassee, FL

NPI number1124092044
StatusActive
Last updated in NPPESJul 13, 2026

Details

NPI
1124092044
Entity type
Individual (NPI-1)
Name
Dr. Bansidas M Agravat
Credential
M.D
Sex
Male
Sole proprietor
No
Enumeration date
Feb 15, 2006
Last updated
Jul 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency MedicineME25973FLYes

Practice location

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Phone 850-431-0756 · Fax 850-431-0779

Mailing address

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Phone 850-431-0756 · Fax 850-431-0779

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