=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720264153
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DANIEL L. RITZ
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2008
-----------------------------------------------------
Last Update Date | 02/22/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6290 SW HIGHWAY 200
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34476-5556
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-237-6200
-----------------------------------------------------
Fax | 352-237-9284
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6290 SW HIGHWAY 200
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34476-5556
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-237-6200
-----------------------------------------------------
Fax | 352-237-9284
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST
-----------------------------------------------------
Name | DANIEL L RITZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-237-6200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 2305
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------