Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | TRN25785 | FL |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | TRN25785 | FL |
NPI | 1598150153 |
---|---|
Provider Name | Dr. Ryan Jeremy Hidalgo |
First Address | Tampa, FL 33602-3190 |
Second Address | Tampa, FL 33606-3571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 06/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TRN25785 | FLORIDA DEPARTMENT OF HEALTH (01) | FL |