Provider Demographics
NPI:1669493219
Name:KNIGHT-HANTMAN, HARLYNE BETH (OD)
Entity Type:Individual
Prefix:DR
First Name:HARLYNE
Middle Name:BETH
Last Name:KNIGHT-HANTMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2116 NW 19TH WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6302
Mailing Address - Country:US
Mailing Address - Phone:561-994-3648
Mailing Address - Fax:561-994-3648
Practice Address - Street 1:17940 MILITARY TRL STE 400
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2411
Practice Address - Country:US
Practice Address - Phone:561-912-7252
Practice Address - Fax:561-912-0802
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL1537152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT54776Medicare UPIN
FL20179Medicare PIN