Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | ME71162 | FL |
NPI | 1336123017 |
---|---|
Provider Name | Dr. David Clement Ritter |
First Address | Tampa, FL 33622-0642 |
Second Address | Bonita Springs, FL 34135-4773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 27/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250640800 | (05) | FL |
32186 | BCBS (01) | FL |
F85913 | (02) | FL |