Provider Demographics
NPI:1356103147
Name:KNAPP, YOLANDA COLLAZO (LSA, CST/CSFA)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:COLLAZO
Last Name:KNAPP
Suffix:
Gender:F
Credentials:LSA, CST/CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:29253 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2102
Mailing Address - Country:US
Mailing Address - Phone:727-313-4764
Mailing Address - Fax:727-313-4764
Practice Address - Street 1:29253 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2102
Practice Address - Country:US
Practice Address - Phone:727-313-4764
Practice Address - Fax:727-313-4764
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0136000795363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical