Provider Demographics
NPI:1720131865
Name:GABRIELE P KNAUS M D PA
Entity type:Organization
Organization Name:GABRIELE P KNAUS M D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELE
Authorized Official - Middle Name:P
Authorized Official - Last Name:KNAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-625-1263
Mailing Address - Street 1:3355 BURNS RD STE 203
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4355
Mailing Address - Country:US
Mailing Address - Phone:561-625-1263
Mailing Address - Fax:561-625-3594
Practice Address - Street 1:3355 BURNS RD STE 203
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4355
Practice Address - Country:US
Practice Address - Phone:561-625-1263
Practice Address - Fax:561-625-3594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004963OtherNEIGHBORHOOD HEALTH
FL269100100Medicaid
FL080163013OtherMEDICARE RAILROAD
FL23363OtherBLUE CROSS/BLUE SHIELD
NY1529766OtherGHI
FL23363YMedicare PIN
FL004963OtherNEIGHBORHOOD HEALTH