Individual
JASON RITENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8026 S TAMIAMI TRL STE 103, VENICE, FL 34293-5113
(239) 690-6906
Mailing address
7709 MAMOUTH ST, ENGLEWOOD, FL 34224
(919) 830-6599
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71011474A
IN
363LF0000X
Family Nurse Practitioner
APRN11012847
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11012847
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300053890
—
IN
Enumeration date
05/05/2021
Last updated
02/28/2025
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