Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | ME113504 | FL |
Y | 207ND0101X | MOHS-Micrographic Surgeon | ME113504 | FL |
N | 207ND0900X | Dermatopathologist | ME113504 | FL |
NPI | 1023246527 |
---|---|
Provider Name | Charles F Knapp III |
First Address | The Villages, FL 32163-2005 |
Second Address | The Villages, FL 32163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 22/03/2021 |