Provider Demographics
NPI:1235787367
Name:RITTER, LINDA LOU
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LOU
Last Name:RITTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-4409
Mailing Address - Country:US
Mailing Address - Phone:863-815-1843
Mailing Address - Fax:
Practice Address - Street 1:7312 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-4409
Practice Address - Country:US
Practice Address - Phone:863-815-1843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-02
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider