MEDICARE: CHARLES A RITCHIE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	ME134056	FL
2	2085R0204X	Vascular & Interventional Radiology Physician	ME134056	FL
3	2085R0202X	Diagnostic Radiology Physician	33323	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083877799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES A RITCHIE MD

Provider Business Mailing Address
First Line	:	4500 SAN PABLO RD S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-1865
Country	:	US
Telephone Number	:	904-953-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	8791 CONFERENCE DR STE 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-5822
Country	:	US
Telephone Number	:	239-331-5566
Fax Number	:	239-437-7499

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	11/04/2025

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