Provider Demographics
NPI:1629415724
Name:KNIGHT NEUROLOGY LLC
Entity Type:Organization
Organization Name:KNIGHT NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-345-6331
Mailing Address - Street 1:211 CORAL SANDS DR STE B
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2749
Mailing Address - Country:US
Mailing Address - Phone:321-345-6331
Mailing Address - Fax:321-345-3295
Practice Address - Street 1:211 CORAL SANDS DR STE B
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2749
Practice Address - Country:US
Practice Address - Phone:321-345-6331
Practice Address - Fax:321-345-3295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty