Provider Demographics
NPI:1912991498
Name:MICHEL KNOWLES, CYNTHIA (DO)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:MICHEL KNOWLES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NW 70TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2385
Mailing Address - Country:US
Mailing Address - Phone:954-382-5208
Mailing Address - Fax:954-382-5338
Practice Address - Street 1:333 NW 70TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2385
Practice Address - Country:US
Practice Address - Phone:954-382-5208
Practice Address - Fax:954-382-5338
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44486OtherBCBS OF FL
FL5537600OtherAETNA
FL0402112OtherUNITED HEALTHCARE
FL254754600Medicaid
FL1885601012OtherCIGNA
FL39846OtherNEIGHBORHOOD
FL116005FOtherAMERIGROUP
FL203022045OtherCBCA
FL203022045OtherTOTAL CLAIMS ADMINISTRATO
FL203022045OtherVISTA
FL232536OtherSTATWELL
FL203022045OtherHUMANA
FL279822OtherAVMED
FL232536OtherSTATWELL
FLG75642Medicare UPIN
FL254754600Medicaid