Organization
SPEKTRUM HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH ANTHONY KNOLL APRN (CEO)
(407) 454-1363
Entity
Organization
Contact information
Practice address
5205 S ORANGE AVE STE 110, ORLANDO, FL 32809-3067
(407) 454-1363
(321) 247-7391
Mailing address
5205 S ORANGE AVE STE 110, ORLANDO, FL 32809-3067
(407) 454-1363
(321) 247-7391
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015139500
—
FL
01
—
0WDSQ
FLORIDA BLUE
FL
01
—
1061098
CIGNA
FL
Enumeration date
11/15/2018
Last updated
01/26/2022
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