Individual
DR. GUS MITSOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 SOUTH ASHLEY DRIVE, SUITE 1500, TAMPA, FL 33602-5318
(813) 899-6220
(813) 985-8006
Mailing address
100 SOUTH ASHLEY DRIVE, SUITE 1500, TAMPA, FL 33602-5318
(813) 899-6220
(813) 985-8006
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME119893
FL
2085R0204X
Vascular & Interventional Radiology Physician
ME119893
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012467100
—
FL
Enumeration date
08/03/2011
Last updated
07/10/2015
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