MEDICARE: PROF. CHERYL KNIGHT P.A.

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	363AM0700X	Medical Physician Assistant	PA9103259	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	:	1457490831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. CHERYL KNIGHT P.A.

Provider Business Mailing Address
First Line	:	1996 KINGSLEY AVE
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-4442
Country	:	US
Telephone Number	:	904-276-5700
Fax Number	:	904-272-1474

Provider Business Practice Location Address
First Line	:	7207 GOLDEN WINGS RD STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-3324
Country	:	US
Telephone Number	:	904-389-1010
Fax Number	:	904-389-1082

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/21/2022

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