Provider Demographics
NPI:1447690870
Name:RITZ, REBECCA LEE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LEE
Last Name:RITZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 CROSSHAIR CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7408
Mailing Address - Country:US
Mailing Address - Phone:407-240-0858
Mailing Address - Fax:
Practice Address - Street 1:2111 CROSSHAIR CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7408
Practice Address - Country:US
Practice Address - Phone:407-240-0858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-30
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1878612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health