Healthcare Provider Details

I. General information

NPI: 1134035868
Provider Name (Legal Business Name): LYNDSEY RITCHIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BUCKTAIL AVE
PONTE VEDRA FL
32081-6180
US

IV. Provider business mailing address

41 BUCKTAIL AVE
PONTE VEDRA BEACH FL
32081-6180
US

V. Phone/Fax

Practice location:
  • Phone: 904-314-1016
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA10450
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: