Organization
NORTH COUNTY DERMATOLOGY CLINIC PA
Active
Organization
NORTH COUNTY DERMATOLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY E KNIGHT M.D. (PRESIDENT)
(863) 853-3331
Entity
Organization
Contact information
Practice address
6500 N SOCRUM LOOP RD, SUITE 100, LAKELAND, FL 33809-4179
(863) 853-3331
(863) 853-3337
Mailing address
6500 N SOCRUM LOOP RD, SUITE 100, LAKELAND, FL 33809-4179
(863) 853-3331
(863) 853-3337
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-00964
UNITED HEALTH CARE
FL
01
—
08166
UNIVERSAL
FL
01
—
11246701
CITRUS
FL
01
—
1716600
AETNA HMO
FL
01
—
2122854621301
BEECHSTREET
FL
05
—
265978600
—
FL
01
—
490487144
TRICARE
FL
01
—
62853
BCBS
FL
01
—
7988417
AETNA TRADITIONAL
FL
01
—
DG5508
RAILROAD MEDICARE GROUP
FL
01
—
P0044110
RAILROAD INDIVIDUAL
FL
Enumeration date
04/10/2007
Last updated
09/05/2025
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