Provider Demographics
NPI:1316023161
Name:AGUILA, WILFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:WILFRED
Middle Name:
Last Name:AGUILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8561 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3731
Mailing Address - Country:US
Mailing Address - Phone:844-981-8446
Mailing Address - Fax:813-749-0214
Practice Address - Street 1:8561 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625
Practice Address - Country:US
Practice Address - Phone:844-981-8446
Practice Address - Fax:813-749-0214
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63020207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
01144OtherUNIVERSAL
5796379OtherGHI
0667834OtherAETNA
31885OtherBLUECROSS/BLUESHIELD
020031899OtherR.R.MEDICARE
208871OtherAVMED
7242098001OtherCIGNA HMO
206986OtherAMERIGROUP
FL268866200Medicaid
FL268866200Medicaid
G30975Medicare UPIN