Provider Demographics
NPI:1346512829
Name:RITTEL, LORI SUSAN (MS RD LD)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:SUSAN
Last Name:RITTEL
Suffix:
Gender:F
Credentials:MS RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349A 27TH STREET OCEAN
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-4201
Mailing Address - Country:US
Mailing Address - Phone:406-439-5040
Mailing Address - Fax:305-289-2479
Practice Address - Street 1:3333 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2329
Practice Address - Country:US
Practice Address - Phone:305-289-2718
Practice Address - Fax:305-289-2479
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5706133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered