Provider Demographics
NPI:1184689739
Name:KNOWLTON, SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:KNOWLTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10115 FOREST HILL BLVD
Mailing Address - Street 2:SUITE103
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3105
Mailing Address - Country:US
Mailing Address - Phone:561-328-6165
Mailing Address - Fax:561-328-6091
Practice Address - Street 1:10115 FOREST HILL BLVD
Practice Address - Street 2:SUITE103
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3105
Practice Address - Country:US
Practice Address - Phone:561-328-6165
Practice Address - Fax:561-328-6091
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72290207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251974700Medicaid
FL32759AMedicare ID - Type Unspecified
FL251974700Medicaid