Individual
DR. RAYMOND R KNISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1255 STATE ROAD 60 E STE 100, LAKE WALES, FL 33853-4310
(863) 589-5685
(863) 589-5639
Mailing address
7652 ASHLEY PARK CT STE 305, ORLANDO, FL 32835-6199
(407) 299-7333
(863) 589-5639
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS12508
FL
207NS0135X
Procedural Dermatology Physician
OS12508
FL
Other
Enumeration date
01/17/2006
Last updated
11/02/2021
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