Provider Demographics
NPI:1720362999
Name:KNIGHT, SAMUEL B (CRNA)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:B
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1613 N HARRISON PARKWAY #200
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2853
Mailing Address - Country:US
Mailing Address - Phone:954-832-2371
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:11750 SW 40TH STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-227-5557
Practice Address - Fax:305-551-2039
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA667490163W00000X
FL9328944163W00000X
FLARNP9328944367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse