MEDICARE: DR. HARLYNE BETH KNIGHT-HANTMAN OD

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	152WL0500X	Low Vision Rehabilitation Optometrist	FL1537	FL

General Provider Information

NPI Number	:	1669493219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARLYNE BETH KNIGHT-HANTMAN OD

Provider Business Mailing Address
First Line	:	2116 NW 19TH WAY
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-6302
Country	:	US
Telephone Number	:	561-994-3648
Fax Number	:	561-994-3648

Provider Business Practice Location Address
First Line	:	5030 CHAMPION BLVD # C2A
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-2473
Country	:	US
Telephone Number	:	561-912-7252
Fax Number	:	561-912-0802

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	05/07/2024

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