Healthcare Provider Details

I. General information

NPI: 1437410362
Provider Name (Legal Business Name): MYRIANNE PYRAM KNOX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12221 COLONY PRESERVE DR
BOYNTON BEACH FL
33436-5807
US

IV. Provider business mailing address

12221 COLONY PRESERVE DR
BOYNTON BEACH FL
33436-5807
US

V. Phone/Fax

Practice location:
  • Phone: 305-336-9923
  • Fax:
Mailing address:
  • Phone: 305-336-9923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT8625
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberRT8625
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: