Healthcare Provider Details

I. General information

NPI: 1801472899
Provider Name (Legal Business Name): THOMAS RODENHOUSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E FOWLER AVE STE 100
TEMPLE TERRACE FL
33617-2305
US

IV. Provider business mailing address

5901 E FOWLER AVE STE 100
TEMPLE TERRACE FL
33617-2305
US

V. Phone/Fax

Practice location:
  • Phone: 813-978-9700
  • Fax:
Mailing address:
  • Phone: 813-978-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME179559
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: