MEDICARE: DR. DEBORAH KNUDSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME131782	FL
2	2084P0800X	Psychiatry Physician	246772	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	T280A	OTHER	FL	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104016633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH KNUDSON MD

Provider Business Mailing Address
First Line	:	809 S FREMONT AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2814
Country	:	US
Telephone Number	:	813-409-1729
Fax Number	:

Provider Business Practice Location Address
First Line	:	3848 FLATIRON LOOP UNIT 102
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-7825
Country	:	US
Telephone Number	:	857-201-0228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	04/20/2026

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