Healthcare Provider Details

I. General information

NPI: 1992574735
Provider Name (Legal Business Name): CHRISTIAN RITACCO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6302 E SABER LOOP UNIT A
TUCSON AZ
85708-1188
US

IV. Provider business mailing address

6302 E SABER LOOP UNIT A
TUCSON AZ
85708
US

V. Phone/Fax

Practice location:
  • Phone: 850-218-6885
  • Fax:
Mailing address:
  • Phone: 850-218-6885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: