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General NPI Number Information
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NPI Number | 1629196811
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Entity Type | Individual
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Provider Name | MATTHEW M RAGSDELL DO
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 1615 PASADENA AVE S STE 290
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City | SOUTH PASADENA
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State | FL
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Zip | 33707-4517
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Country | US
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Telephone | 727-826-0329
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Fax | 727-202-7193
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Provider Business Mailing Address
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Address Line | 1615 PASADENA AVE S STE 290
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City | SOUTH PASADENA
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State | FL
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Zip | 33707-4517
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Country | US
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Telephone | 727-826-0329
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Fax | 727-202-7193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 2004015332
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 5101015376
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | OS13422
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License Number State | FL
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