MEDICARE: JOSEPH WELLS AGUIAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	ME82789	FL
2	208200000X	Plastic Surgery Physician	31448	IA
3	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	ME82789	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01119X	OTHER	FL	MEDICARE

General Provider Information

NPI Number	:	1902884299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH WELLS AGUIAR MD

Provider Business Mailing Address
First Line	:	12015 WHITMARSH LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1737
Country	:	US
Telephone Number	:	813-658-3600
Fax Number	:	813-739-0917

Provider Business Practice Location Address
First Line	:	12015 WHITMARSH LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1737
Country	:	US
Telephone Number	:	813-658-3600
Fax Number	:	813-739-0917

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/05/2012

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