Provider Demographics
NPI:1912017005
Name:FLORIDA KNEE CENTER INC
Entity Type:Organization
Organization Name:FLORIDA KNEE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-446-5633
Mailing Address - Street 1:1660 GULF TO BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-6423
Mailing Address - Country:US
Mailing Address - Phone:727-446-5633
Mailing Address - Fax:727-447-6312
Practice Address - Street 1:1660 GULF TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-6423
Practice Address - Country:US
Practice Address - Phone:727-446-5633
Practice Address - Fax:727-447-6312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97792Medicare PIN
FL5595870001Medicare NSC