Provider Demographics
| NPI: | 1003311861 |
|---|---|
| Name: | RENDEL, RICARDO EMMANUEL (MD) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | RICARDO |
| Middle Name: | EMMANUEL |
| Last Name: | RENDEL |
| Suffix: | |
| Gender: | M |
| Credentials: | MD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | PO BOX 917770 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ORLANDO |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 32891-0001 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 813-821-8038 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2 TAMPA GENERAL CIR |
| Practice Address - Street 2: | |
| Practice Address - City: | TAMPA |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33606-3571 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 813-821-8038 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2018-03-26 |
| Last Update Date: | 2025-11-17 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| FL | ME171270 | 2086S0102X, 2086S0102X, 2086S0127X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2086S0127X | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | Group - Multi-Specialty |
| Yes | 2086S0102X | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| FL | MLMX9 | Other | BCBS |
| FL | 128091700 | Medicaid |