DR. RAYMOND R KNISLEY (NPI# 1932189008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932189008 |
| Entity Type | Individual |
| Full Name | DR. RAYMOND R KNISLEY |
| Credential | DO |
| Practice Address |
421 Linden Ln Lake Wales FL 33853-4342 |
| Mailing Address |
405 W Bloomingdale Ave Brandon FL 33511-7401 |
| Practice Telephone | 8636763411 |
| Practice Fax Number | 8636761015 |
| Mailing Telephone | 8137897616 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2019-08-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | OS12508 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1052 Downing Cir, Wauchula, FL 338733358 | 8553537546 | 8637743526 |
| 3725 S Hwy 27, Ste 105, Clermont, FL 34711 | 8553537546 | 3525334391 |
| Street Address |
421 LINDEN LN |
| City | LAKE WALES |
| State | FL |
| Zip Code | 33853-4342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457823809 | Brandon Tyler Worley | Dermatology | 421 Linden Ln, Lake Wales, FL 33853-4342 | 2018-12-26 |
| 1225493984 | Merrill Ann Hart | Physician Assistant | 421 Linden Ln, Lake Wales, FL 33853-4342 | 2015-12-23 |
| 1750458535 | Stephen J Plumb | Dermatology | 421 Linden Ln, Lake Wales, FL 33853-4342 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218998 | Marcel Fundora | Dentist | 701 Fl-60, Lake Wales, FL 33853 | 2020-06-04 |
| 1386291599 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 1255 Florida 60, Suite 300, Lake Wales, FL 33853 | 2019-08-22 |
| 1932753472 | Adeline Brooke Warren | Occupational Therapist | 512 S 11th Street, Lake Wales, FL 33853 | 2019-08-01 |
| 1033563580 | Amber Y Shepard | Family Medicine | 1255 Highway 60 E Ste 500, Lake Wales, FL 33853 | 2016-04-21 |
| 1174982458 | Ledesha Marie Dorothy Maduro | Dentist | 24185 Us Hwy 27 North, Lake Wales, FL 33853 | 2016-02-16 |
| 1528402435 | Buck Andreu Scott | Surgery | 407 S 11th St, Lake Wales, FL 33853 | 2013-04-22 |
| 1447598321 | Central Florida Health Care, Inc. | Dentist | 305 West Central Avenue, Lake Wales, FL 33853 | 2013-01-28 |
| 1972864932 | Kevin T Barlow, Pa. Dba: Winter Haven Audiology and Ridge Audiology. | Clinic/Center | 704 Sr 60 East, Lake Wales, FL 33853 | 2012-06-06 |
| 1316266364 | Elba M Lopez | Massage Therapist | 318 S. First Street, Lake Wales, FL 33853 | 2010-05-28 |
| 1063657955 | Lake Wales Medical Imaging Center One, Inc | Technician, Health Information | 1255 Highway 60 East 110, Lake Wales, FL 33853 | 2008-12-08 |
| Find all providers in zip 33853 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548217482 | Eduvigia Ancaya | Dermatology | 1611 State Road 60 E, Lake Wales, FL 33853-4309 | 2006-05-27 |
| 1457823809 | Brandon Tyler Worley | Dermatology | 421 Linden Ln, Lake Wales, FL 33853-4342 | 2018-12-26 |
| 1124152095 | James D. Morgan, Md, Pa | Dermatology | 1109 Bryn Mawr Ave, Lake Wales, FL 33853-4333 | 2007-03-15 |
| 1194765271 | James D Morgan | Dermatology | 1109 Bryn Mawr Ave, Lake Wales, FL 33853-4333 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
| Find all providers with the same taxonomy | ||||
| City | LAKE WALES |
| Zip Code | 33853 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.