Provider Demographics
NPI:1982658332
Name:KNOWLES, MAX (AP,DOM)
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:AP,DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 278195
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-8195
Mailing Address - Country:US
Mailing Address - Phone:954-443-1058
Mailing Address - Fax:954-430-5852
Practice Address - Street 1:17901 NW 5TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2810
Practice Address - Country:US
Practice Address - Phone:954-443-1058
Practice Address - Fax:954-443-7990
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP841171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist