MEDICARE: DR. SARAH KNOWLTON M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME72290	FL

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

General Provider Information

NPI Number	:	1184689739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH KNOWLTON M.D.

Provider Business Mailing Address
First Line	:	10115 FOREST HILL BLVD
Second Line	:	SUITE103
City	:	WELLINGTON
State	:	FL
Zip	:	33414-3105
Country	:	US
Telephone Number	:	561-328-6165
Fax Number	:	561-328-6091

Provider Business Practice Location Address
First Line	:	10115 FOREST HILL BLVD
Second Line	:	SUITE103
City	:	WELLINGTON
State	:	FL
Zip	:	33414-3105
Country	:	US
Telephone Number	:	561-328-6165
Fax Number	:	561-328-6091

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	08/22/2011

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