MEDICARE: AMY KNECHT

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	174400000X	Specialist	1044 OT	FL

General Provider Information

NPI Number	:	1972926657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY KNECHT

Provider Business Mailing Address
First Line	:	6110 CYPRESS GARDENS BLVD
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-4142
Country	:	US
Telephone Number	:	863-318-8055
Fax Number	:	863-325-8522

Provider Business Practice Location Address
First Line	:	6110 CYPRESS GARDENS BLVD
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-4142
Country	:	US
Telephone Number	:	863-318-8055
Fax Number	:	863-325-8522

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

Provider Enumeration Date	:	01/30/2014
Last Update Date	:	01/30/2014

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