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General NPI Number Information
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NPI Number | 1396634713
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Entity Type | Individual
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Provider Name | LUKE TRISTAN RITTER
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Gender | Male
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 201 N CLYDE MORRIS BLVD STE 3203211
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2724
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Country | US
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Telephone | 386-236-7017
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4312
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Country | US
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Telephone | 904-345-7251
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E3775585
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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