Provider Demographics
NPI:1972926657
Name:KNECHT, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KNECHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 CYPRESS GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-4142
Mailing Address - Country:US
Mailing Address - Phone:863-318-8055
Mailing Address - Fax:863-325-8522
Practice Address - Street 1:6110 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-4142
Practice Address - Country:US
Practice Address - Phone:863-318-8055
Practice Address - Fax:863-325-8522
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1044 OT174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist