Provider Demographics
NPI:1629196811
Name:RAGSDELL, MATTHEW M (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:M
Last Name:RAGSDELL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1615 PASADENA AVE S STE 290
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4517
Mailing Address - Country:US
Mailing Address - Phone:727-826-0329
Mailing Address - Fax:727-202-7193
Practice Address - Street 1:1615 PASADENA AVE S STE 290
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4517
Practice Address - Country:US
Practice Address - Phone:727-826-0329
Practice Address - Fax:727-202-7193
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2004015332207XX0005X
MI5101015376207XX0005X
FLOS13422207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine