Provider Demographics
NPI:1881789535
Name:RITZ, DANIEL L (OD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:RITZ
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 1:6290 SW HIGHWAY 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-5556
Mailing Address - Country:US
Mailing Address - Phone:352-237-6200
Mailing Address - Fax:352-237-9284
Practice Address - Street 1:6290 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-5556
Practice Address - Country:US
Practice Address - Phone:352-237-6200
Practice Address - Fax:352-237-9284
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2305152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078560100Medicaid
FL078560101Medicaid
FL20299OtherBCBS
FL078560101Medicaid
FL078560100Medicaid
FL20299YMedicare PIN
FL593067392OtherTAX ID NUMBER