Healthcare Provider Details

I. General information

NPI: 1194727586
Provider Name (Legal Business Name): JAMES MATTHEW KNIGHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N ORANGE AVE SUITE 520
ORLANDO FL
32801-1026
US

IV. Provider business mailing address

801 N ORANGE AVE SUITE 520
ORLANDO FL
32801-1026
US

V. Phone/Fax

Practice location:
  • Phone: 407-992-0660
  • Fax: 407-992-7702
Mailing address:
  • Phone: 407-992-0660
  • Fax: 407-992-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberME89879
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: