Provider Demographics
NPI:1629852215
Name:SADDLER, RIDELL JAMELL
Entity Type:Individual
Prefix:MR
First Name:RIDELL
Middle Name:JAMELL
Last Name:SADDLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E 12TH AVE UNIT 5103
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33675-9006
Mailing Address - Country:US
Mailing Address - Phone:844-543-1214
Mailing Address - Fax:
Practice Address - Street 1:2000 E 12TH AVE UNIT 5103
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33675-9006
Practice Address - Country:US
Practice Address - Phone:844-543-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company