Provider Demographics
NPI:1558866517
Name:RODRIGUEZ, RYAN GUSTAVO (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:GUSTAVO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4129 N ARMENIA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6436
Mailing Address - Country:US
Mailing Address - Phone:813-879-3699
Mailing Address - Fax:813-873-8469
Practice Address - Street 1:4129 N ARMENIA AVE STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6436
Practice Address - Country:US
Practice Address - Phone:813-879-3699
Practice Address - Fax:813-873-8469
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1668332086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care