Individual
DR. RYAN JEREMY HIDALGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 259-8500
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
TRN25785
FL
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
ME154438
FL
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
TRN25785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114884000
—
FL
01
—
VQ22H
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/31/2015
Last updated
03/30/2023
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