Healthcare Provider Details

I. General information

NPI: 1174089395
Provider Name (Legal Business Name): KNR THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 TECH BLVD STE 104
TAMPA FL
33619-7863
US

IV. Provider business mailing address

1202 TECH BLVD STE 103
TAMPA FL
33619-7863
US

V. Phone/Fax

Practice location:
  • Phone: 813-438-6796
  • Fax: 813-252-1367
Mailing address:
  • Phone: 813-598-7447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: FRANK BEQUER
Title or Position: SOLE MEMBER
Credential:
Phone: 813-438-6796