Mitsopoulos, Gus

Mitsopoulos, Gus is an individual health care provider with primary practice located at 100 South Ashley Drive Suite 1500, Tampa FL 33602-5318. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Mitsopoulos, Gus can be contacted via phone (813) 899-6220.

Contact Information

Primary practice address
100 South Ashley Drive Suite 1500 Tampa FL 33602-5318
Phone: (813) 899-6220
Fax: (813) 985-8006
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X ME119893 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME119893 Florida

Profile Details

NPI number 1750669032
LBN Legal business name Mitsopoulos, Gus
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2011
Last updated Jul 10th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750669032 NPPES
Florida MEDICAID 012467100

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