Provider Demographics
NPI:1023418126
Name:KNOLL, JOSEPH ANTHONY (MSN, ARNP)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:KNOLL
Suffix:
Gender:M
Credentials:MSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 S ORANGE AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-6748
Mailing Address - Country:US
Mailing Address - Phone:407-454-1363
Mailing Address - Fax:863-229-2576
Practice Address - Street 1:8000 S ORANGE AVE STE 210
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-6748
Practice Address - Country:US
Practice Address - Phone:407-454-1363
Practice Address - Fax:863-229-2576
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9309409363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015139500Medicaid
FLQ27GAOtherBCBS