Provider Demographics
NPI:1922622356
Name:RITCH, CARL (OD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:RITCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4068 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6775
Mailing Address - Country:US
Mailing Address - Phone:407-892-0063
Mailing Address - Fax:407-846-7658
Practice Address - Street 1:4068 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769
Practice Address - Country:US
Practice Address - Phone:407-892-0063
Practice Address - Fax:407-846-7658
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5818152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist