Provider Demographics
NPI:1710455258
Name:KNIGHTS, NICOLE M (DPT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:KNIGHTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6431 LAKE ANDREW DR UNIT 103
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7250
Mailing Address - Country:US
Mailing Address - Phone:321-473-6773
Mailing Address - Fax:321-473-3002
Practice Address - Street 1:6431 LAKE ANDREW DR UNIT 103
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7250
Practice Address - Country:US
Practice Address - Phone:321-473-6773
Practice Address - Fax:321-473-3002
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34044225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist