Provider Demographics
NPI:1477945814
Name:MARK L. RITCH DO, PA
Entity Type:Organization
Organization Name:MARK L. RITCH DO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:RITCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-209-2662
Mailing Address - Street 1:1000 BELCHER RD S
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3321
Mailing Address - Country:US
Mailing Address - Phone:727-209-2662
Mailing Address - Fax:727-400-3233
Practice Address - Street 1:1000 BELCHER RD S
Practice Address - Street 2:SUITE 6
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3321
Practice Address - Country:US
Practice Address - Phone:727-209-2662
Practice Address - Fax:727-400-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS00065662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty