Healthcare Provider Details
I. General information
NPI: 1316635139
Provider Name (Legal Business Name): RITZ THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2023
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21511 ELDRED AVE
PORT CHARLOTTE FL
33952-1609
US
IV. Provider business mailing address
21511 ELDRED AVE
PORT CHARLOTTE FL
33952-1609
US
V. Phone/Fax
- Phone: 502-249-3155
- Fax:
- Phone: 502-249-3155
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XF0002X |
| Taxonomy | Feeding, Eating & Swallowing Occupational Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NEREIDA
RITZ
Title or Position: MANAGER
Credential: OTD, OTR/L
Phone: 502-249-3155