LAKE WALES DERMATOLOGY
NPI 1962088138
Dermatology in Lake Wales, FL
About Lake Wales Dermatology NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE WALES DERMATOLOGY (NPI 1962088138) is a healthcare organization registered as a dermatology in Lake Wales, Florida and active in the NPI registry since March 2021. The organization maintains a secondary practice location in Lake Wales and lists Raymond Knisley, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Group Practice 1
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Distinctive Dermatology PLLC's NPI number?
The NPI number for Distinctive Dermatology PLLC is 1962088138. It was assigned to this organization in the NPPES registry on March 19, 2021. The provider is doing business as Lake Wales Dermatology.
Where is Distinctive Dermatology PLLC located?
Distinctive Dermatology PLLC is located at 134 E Tillman Ave, Lake Wales, FL 33853. The listed phone number is (863) 269-0790.
What is Distinctive Dermatology PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
When was this NPI record last updated?
The NPPES record for Distinctive Dermatology PLLC was last updated on April 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.