Healthcare Provider Details

I. General information

NPI: 1609786615
Provider Name (Legal Business Name): MADISON MCKNIGHT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4408
US

IV. Provider business mailing address

800 EVERETT WAY APT 712
PERRY FL
32348-6374
US

V. Phone/Fax

Practice location:
  • Phone: 850-294-3249
  • Fax:
Mailing address:
  • Phone: 856-246-2015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: