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General NPI Number Information
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NPI Number | 1285836718
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Entity Type | Individual
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Provider Name | COLIN G KNIGHT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 2402 FRIST BLVD STE 204
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City | FORT PIERCE
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State | FL
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Zip | 34950-4838
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Country | US
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Telephone | 772-462-3939
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Fax | 772-462-3938
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Provider Business Mailing Address
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Address Line | 11760 SW 40TH ST STE 722
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City | MIAMI
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State | FL
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Zip | 33175-8101
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Country | US
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Telephone | 305-559-1334
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Fax | 305-559-3168
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | ME-99402
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License Number State | FL
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