Healthcare Provider Details

I. General information

NPI: 1164782090
Provider Name (Legal Business Name): RYAN NORWOOD HOECKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

6113 S RUSSELL ST
TAMPA FL
33611-4750
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME126019
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME126019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: