Active NPI
Ronald Pobre Vicencio, M.D.
- Family Medicine Physician
- Tampa, FL
National Provider Identifier
1689626723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME67267
- Practice address
- 10910 Sheldon Rd
Tampa, FL 33626-4701 - Phone
- (813) 544-1465
- Fax
- (813) 537-8848
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME67267 | FL | Primary |
Addresses
Primary practice location
10910 Sheldon Rd
Tampa, FL 33626-4701
Mailing address
10910 Sheldon Rd
Tampa, FL 33626-4701
Phone (813) 544-1465
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 256560901 | Medicaid | FL | |
| 080115574 | Other | FL | RAILROAD MEDICARE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 26, 2020 through Mar 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- ronald.vicencio@235874509389828.direct.elationemr.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768262400000",
"number": "1689626723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10910 SHELDON RD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336264701",
"telephone_number": "813-544-1465",
"fax_number": "813-537-8848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10910 SHELDON RD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336264701",
"telephone_number": "813-544-1465",
"fax_number": "813-537-8848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICENCIO",
"first_name": "RONALD",
"middle_name": "POBRE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2026-01-13",
"certification_date": "2026-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME67267",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "256560901",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE NUMBER",
"identifier": "080115574",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.