Provider Demographics
NPI:1972773414
Name:DANIEL L RITZ
Entity Type:Organization
Organization Name:DANIEL L RITZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPING/BUS. MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-245-9000
Mailing Address - Street 1:5215 SE ABSHIER BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-3916
Mailing Address - Country:US
Mailing Address - Phone:352-245-9000
Mailing Address - Fax:352-347-6008
Practice Address - Street 1:5215 SE ABSHIER BLVD
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3916
Practice Address - Country:US
Practice Address - Phone:352-245-9000
Practice Address - Fax:352-347-6008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOB2137152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0508450002Medicare NSC
FLK1381AMedicare PIN