Individual provider Active NPI

Ryan Gustavo Rodriguez, MD

  • Surgical Critical Care Physician
  • Tampa, FL
National Provider Identifier
1558866517
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
ME166833 Issued in FL
Practice address
3820 Northdale Blvd Ste 201
Tampa, FL 33624-1893
Phone
(800) 991-6117
Fax
(888) 812-8191
NPI assigned
Mar 29, 2018
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X ME166833 FL Primary
Phlebology Physician 202K00000X ME166833 FL

Addresses

Primary practice location

3820 Northdale Blvd Ste 201
Tampa, FL 33624-1893

Mailing address

3820 Northdale Blvd Ste 201
Tampa, FL 33624-1893
Phone (800) 991-6117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828004107 FL Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 0648522474 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3209 Liberty St
Hollywood, FL 33021-3713

3820 Northdale Blvd
Suite 201
Tampa, FL 33624-1893

4129 N Armenia Ave
Suite B
Tampa, FL 33607-6436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME166833FLMDPhlebology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wazni, PLLC CurrentSince Apr 1, 2026 Accepting new patients
Tampa Lung Specialists, P.a. CurrentSince Aug 21, 2025 Accepting new patients
Raul Sierra MD PA PastSince Aug 25, 2025 Accepting new patients

Locations

4619 Little Rd
New Pt Richey, FL 34655
Phone (727) 372-9918

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

4129 N Armenia Ave
Tampa, FL 33607
Phone (813) 870-3342

4129 N Armenia Ave
Ste B
Tampa, FL 33607
Phone (813) 877-7526

1314 E Venice Ave
Ste B
Venice, FL 34285

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1558866517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241893",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241893",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RYAN",
        "middle_name": "GUSTAVO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME166833",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME166833",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.