Provider Demographics
NPI:1083623276
Name:CYNTHIA MICHEL KNOWLES DO PA
Entity Type:Organization
Organization Name:CYNTHIA MICHEL KNOWLES DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHEL KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-382-5208
Mailing Address - Street 1:150 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2004
Mailing Address - Country:US
Mailing Address - Phone:954-382-5208
Mailing Address - Fax:954-382-5338
Practice Address - Street 1:150 N UNIVERSITY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2004
Practice Address - Country:US
Practice Address - Phone:954-382-5208
Practice Address - Fax:954-382-5338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 7539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0402112OtherUNITED HEALTH CARE
1885601012OtherCIGNA
232536OtherSTAYWELL
FL254754600Medicaid
279822OtherAVMED
44486OtherBLUECROSS AND BLUESHIELD
5537600OtherAETNA
FL116005OtherAMERIGROUP
39846OtherNHP
=========OtherCBCA
39846OtherNHP
44486OtherBLUECROSS AND BLUESHIELD
5537600OtherAETNA
K9772Medicare ID - Type UnspecifiedRAILROAD
5537600OtherAETNA
232536OtherSTAYWELL
39846OtherNHP
FL254754600Medicaid