DR. GUS MITSOPOULOS (NPI# 1750669032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750669032 |
| Entity Type | Individual |
| Full Name | DR. GUS MITSOPOULOS |
| Credential | MD |
| Practice Address |
100 South Ashley Drive Suite 1500 Tampa FL 33602-5318 |
| Practice Telephone | 8138996220 |
| Practice Fax Number | 8139858006 |
| Mailing Telephone | 8138996220 |
| Mailing Fax Number | 8139858006 |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2015-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME119893 | FL | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
ME119893 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 012467100 | 05 |
| Street Address |
100 SOUTH ASHLEY DRIVE SUITE 1500 |
| City | TAMPA |
| State | FL |
| Zip Code | 33602-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295730877 | Bryant D Thorpe | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2005-06-20 |
| 1336374305 | David D Huang | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2009-05-20 |
| 1720228778 | Jarret Kuo | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2009-03-04 |
| 1487890117 | Joseph Morrell Jr. | Internal Medicine | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2008-12-30 |
| 1235306226 | James M Lee | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2008-05-09 |
| 1164698650 | Ariel David Prager | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2008-05-05 |
| 1942486873 | Michael John Nicholas | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2008-01-10 |
| 1154515716 | Sujit Pradhan | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2007-08-28 |
| 1396958872 | Bret Jared Neiderman | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2007-05-08 |
| 1427068766 | Albert S Chang | Radiology | 100 South Ashley Drive, Suite 1500, Tampa, FL 33602-5318 | 2006-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306482088 | Michael P. Flynn | Radiology | 1003 Bay Harbour Place, Tampa, FL 33602 | 2019-11-18 |
| 1821649211 | Shannon Tracy Munz | Nurse Practitioner | 203 N Marion St, Tampa, FL 33602 | 2019-09-26 |
| 1932682846 | Ferrara Dental Pllc | Dentist | 201 East Kennedy Blvd, Suite 1425, Tampa, FL 33602 | 2018-09-07 |
| 1639668692 | Darrell Wayne Fennell Jr. | Counselor | 400 N Ashley Dr Ste 2600, Tampa, FL 33602 | 2018-05-05 |
| 1093233967 | Synergic Healthcare Solutions LLC | Clinic/Center | 303 W Palm Ave, Tampa, FL 33602 | 2017-08-31 |
| 1568980464 | Drsoncalls | General Practice | 449 S 12th St., Unit 2801, Tampa, FL 33602 | 2017-08-31 |
| 1386178283 | Charles Stuart | Occupational Therapy Assistant | 313 E. Oak Ave, Tampa, FL 33602 | 2017-04-18 |
| 1285172122 | Frank Watson | Chiropractor | 1004 North Florida Ave., Tampa, FL 33602 | 2017-02-10 |
| 1295189801 | Stephanie Buchman | Student in an Organized Health Care Education/Training Program | 1156 Shipwatch Circle, Tampa, FL 33602 | 2016-04-20 |
| 1093189896 | Jonnique Adjmul | Counselor | 300 E Madison St Ste 201, Tampa, FL 33602 | 2015-11-17 |
| Find all providers in zip 33602 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834763 | Tower Imaging LLC | Radiology | 17416 Brookside Trace Ct., Tampa, FL 33647-3589 | 2020-09-01 |
| 1366067712 | Baycare Outpatient Imaging LLC | Radiology | 711 S Dale Mabry Hwy, Tampa, FL 33609-4445 | 2020-06-11 |
| 1306482088 | Michael P. Flynn | Radiology | 1003 Bay Harbour Place, Tampa, FL 33602 | 2019-11-18 |
| 1528526977 | Raddoctor, Pa | Radiology | 9203 Pine Island Ct, Tampa, FL 33647-2301 | 2019-03-05 |
| 1588023261 | Florida Gulfcoast Medical Imaging LLC | Radiology | 9822 Tree Tops Lake Rd, Tampa, FL 33626-4764 | 2016-02-23 |
| 1063803302 | Ahmed Sherif | Radiology | 2 Tampa General Cir # 7035, Usf Dept of Radiology, South Tampa Center, Tampa, FL 33606-3603 | 2015-02-09 |
| 1780015297 | St. Joseph's Diagnostic Center, LLC. | Radiology | 2222 W Swann Ave, Tampa, FL 33606-2426 | 2013-12-09 |
| 1245576651 | Radiology Associates of Tampa Pa | Radiology | 5 Tampa General Cir Ste 800, Harborside Medical Clinic, Tampa, FL 33606-3601 | 2012-12-13 |
| 1427282151 | Eric Matthew Lenz | Radiology | 3004 W San Miguel St, Tampa, FL 33629-6043 | 2009-05-09 |
| 1699929380 | Charles Howard Fisher | Radiology | 4904 Andros Dr, Tampa, FL 33629-4802 | 2008-11-09 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.