Provider Demographics
NPI:1467982389
Name:KIM KNIGHT FLANAGAN, LLC
Entity Type:Organization
Organization Name:KIM KNIGHT FLANAGAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-560-6326
Mailing Address - Street 1:1811 SW 51ST TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5413
Mailing Address - Country:US
Mailing Address - Phone:954-560-6326
Mailing Address - Fax:954-239-7733
Practice Address - Street 1:1730 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3675
Practice Address - Country:US
Practice Address - Phone:954-560-6326
Practice Address - Fax:954-239-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0005828103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty