Healthcare Provider Details

I. General information

NPI: 1083800239
Provider Name (Legal Business Name): DANIEL GLEN KNAUF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 SE 24TH ST
GAINESVILLE FL
32641-7516
US

IV. Provider business mailing address

224 SE 24TH ST
GAINESVILLE FL
32641-7516
US

V. Phone/Fax

Practice location:
  • Phone: 352-334-7917
  • Fax: 352-955-2126
Mailing address:
  • Phone: 352-334-7917
  • Fax: 352-955-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME33605
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: