Dermatology
DISTINCTIVE DERMATOLOGY PLLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1962088138 · enumerated 2021-03-19 · record updated 2021-04-14. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: RAYMOND KNISLEY, Owner · (863) 269-0790
Other names: LAKE WALES DERMATOLOGY
Addresses and phones
- Practice location 134 E TILLMAN AVE, LAKE WALES, FL, 33853-4130 (863) 269-0790 Google Maps Apple Maps OpenStreetMap
- Mailing address 134 E TILLMAN AVE, LAKE WALES, FL, 33853-4130 (863) 269-0790 Google Maps Apple Maps OpenStreetMap
Specialties
- Dermatology 207N00000X · Primary
In this directory
Locations and evidence
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Practice location
LAKE WALES, FL, 338534130
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.