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Individual

THOMAS CHRISTOPHER RIDDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7720 US HIGHWAY 98 W STE 110, MIRAMAR BEACH, FL 32550-7231
(850) 267-1603
(850) 622-3342
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6063
(904) 539-4091

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME168738
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102IC37309
MEDICARE AL PTAN CMS/CAHABA
AL
Enumeration date
04/23/2009
Last updated
10/04/2024
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