Provider Demographics
NPI:1932202272
Name:KNOWLES, HORACE MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:HORACE
Middle Name:MICHAEL
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9350 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32331-8700
Mailing Address - Country:US
Mailing Address - Phone:850-584-2753
Mailing Address - Fax:
Practice Address - Street 1:2057 W. BYRON BUTLER PKWY
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348
Practice Address - Country:US
Practice Address - Phone:850-584-5618
Practice Address - Fax:850-584-5628
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0016015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556050483Medicare ID - Type Unspecified