Provider Demographics
NPI:1417045840
Name:KNIGHT, BRENDA S (OTR/L,CHT)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:S
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:OTR/L,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 RINGLING BLVD
Mailing Address - Street 2:SUITE E120
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5334
Mailing Address - Country:US
Mailing Address - Phone:941-955-2020
Mailing Address - Fax:941-955-2120
Practice Address - Street 1:2831 RINGLING BLVD
Practice Address - Street 2:SUITE E120
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5334
Practice Address - Country:US
Practice Address - Phone:941-955-2020
Practice Address - Fax:941-955-2120
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14682225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0252OtherSTATE LICENSE
AL51536839OtherBLUE CROSS PROVIDER
AL51536839OtherBLUE CROSS PROVIDER