Provider Demographics
NPI:1952573032
Name:KNIGHT, JOHN LOUIS III (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LOUIS
Last Name:KNIGHT
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 EMERALD BAY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-5035
Mailing Address - Country:US
Mailing Address - Phone:727-483-9599
Mailing Address - Fax:727-441-9610
Practice Address - Street 1:200 EMERALD BAY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-5035
Practice Address - Country:US
Practice Address - Phone:727-483-9599
Practice Address - Fax:727-441-9610
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 3889101YM0800X
FLPSY0293010208103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ153MOtherBCBSFL
FL11846712OtherCAQH