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NPI Code Detail

MEDICARE: AVERY J KNAPP JR MD, P.C.

MEDICARE: AVERY J KNAPP JR MD, P.C.
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
1363AM0700XMedical Physician Assistant
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1528873239
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVERY J KNAPP JR MD, P.C.
Provider Business Mailing Address
First Line : 382 NE 191ST ST PMB 688082
Second Line :
City : MIAMI
State : FL
Zip : 33179-3899
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 954 AVE PONCE DE LEON
Second Line :
City : SAN JUAN
State : PR
Zip : 00907-3646
Country : US
Telephone Number : 877-742-2738
Fax Number :
Authorized Official
Title or Position : CEO
Name : AVERY J KNAPP JR.
Credential : M.D.
Telephone Number : 415-903-2000
Provider Enumeration Date : 02/10/2025
Last Update Date : 02/10/2025

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