Individual provider Active NPI

Rodrigo Ruiz-Gamboa, M.D

  • Vascular Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1801226956
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME127488 Issued in FL
Practice address
12700 Creekside LN Ste 301
Fort Myers, FL 33919-3356
Phone
(239) 343-3780
Fax
(239) 343-3781
NPI assigned
Nov 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME127488 FL Primary

Addresses

Primary practice location

12700 Creekside LN Ste 301
Fort Myers, FL 33919-3356

Mailing address

P.O. Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9960

Other practice location 1

708 Del Prado Blvd S Ste 3
Cape Coral, FL 33990-2676
Phone (239) 343-9960

Other practice location 2

8380 Riverwalk Park Blvd
Suite 100
Fort Myers, FL 33919-8758
Phone (239) 343-9960

Other identifiers 1

IdentifierTypeStateIssuer
018053700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rruizgamboa96359@Direct.leememorial.org Lee Memorial Health System

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
I20160914001751 FL Practitioner - Vascular SurgeryPractitioner - General Surgery 1355637513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

12700 Creekside LN
Fort Myers, FL 33919-3356

23450 Via Coconut PT
Estero, FL 34135-1877
Phone (239) 468-0120

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

3227 Lee Blvd
Suite F
Lehigh Acres, FL 33971-1428
Phone (239) 368-0028

708 Del Prado Blvd S
Cape Coral, FL 33990-2676

8960 Colonial Ctr Dr
Fort Myers, FL 33905-7810

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)19
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME127488FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Aug 15, 2016 Accepting new patients
Lee Memorial Health System CurrentSince Aug 15, 2016 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

708 Del Prado Blvd S
Ste 3
Cape Coral, FL 33990
Phone (239) 343-9960

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

12700 Creekside Ln
Ste 301
Fort Myers, FL 33919
Phone (239) 343-3780

8380 Riverwalk Park Blvd
Ste 100
Fort Myers, FL 33919
Phone (239) 343-9960

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rruizgamboa96359@direct.leememorial.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1801226956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9960",
            "fax_number": "239-424-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 CREEKSIDE LN STE 301",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193356",
            "telephone_number": "239-343-3780",
            "fax_number": "239-343-3781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 Del Prado Blvd S Ste 3",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339902676",
            "country_code": "US",
            "telephone_number": "239-343-9960",
            "fax_number": "239-424-4006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8380 Riverwalk Park Blvd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339198758",
            "country_code": "US",
            "telephone_number": "239-343-9960",
            "fax_number": "239-343-9977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ-GAMBOA",
        "first_name": "RODRIGO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-26",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME127488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018053700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rruizgamboa96359@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.