MEDICARE: KAREN ANNE RITZAU PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA 14236	FL

General Provider Information

NPI Number	:	1225245277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ANNE RITZAU PTA

Provider Business Mailing Address
First Line	:	27 LEEWARD CIR
Second Line	:
City	:	TEQUESTA
State	:	FL
Zip	:	33469-2023
Country	:	US
Telephone Number	:	561-744-2249
Fax Number	:	561-743-8645

Provider Business Practice Location Address
First Line	:	3801 PGA BLVD STE 505
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2759
Country	:	US
Telephone Number	:	561-776-8584
Fax Number	:	561-775-2768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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