Healthcare Provider Details

I. General information

NPI: 1184185126
Provider Name (Legal Business Name): MITCHELL TIMOTHY AQUINO SALUDES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 OAKFIELD DR
BRANDON FL
33511-5779
US

IV. Provider business mailing address

PO BOX 320848
TAMPA FL
33679-2848
US

V. Phone/Fax

Practice location:
  • Phone: 813-304-1986
  • Fax: 321-280-2479
Mailing address:
  • Phone: 813-304-1986
  • Fax: 321-280-2479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME181675
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: