Healthcare Provider Details

I. General information

NPI: 1316023161
Provider Name (Legal Business Name): WILFRED AGUILA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8561 W LINEBAUGH AVE
TAMPA FL
33625
US

IV. Provider business mailing address

8561 W LINEBAUGH AVE
TAMPA FL
33625-3731
US

V. Phone/Fax

Practice location:
  • Phone: 844-981-8446
  • Fax: 813-749-0214
Mailing address:
  • Phone: 844-981-8446
  • Fax: 813-749-0214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number63020
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: