Healthcare Provider Details

I. General information

NPI: 1669665451
Provider Name (Legal Business Name): MRS. CINDY LOU MCKNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 41ST STREET OCEAN
MARATHON FL
33050-2373
US

IV. Provider business mailing address

3000 41ST STREET OCEAN
MARATHON FL
33050-2373
US

V. Phone/Fax

Practice location:
  • Phone: 305-434-9000
  • Fax: 305-434-9040
Mailing address:
  • Phone: 305-434-9000
  • Fax: 305-434-9040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: