Wallace, Audrey

Wallace, Audrey is an sole proprietor health care provider with primary practice located at 10000 Bay Pines Blvd , Bay Pines FL 33744-8200. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is her primary health care specialty. Wallace, Audrey can be contacted via phone (727) 398-9545.

Contact Information

Primary practice address
10000 Bay Pines Blvd Bay Pines FL 33744-8200
Phone: (727) 398-9545
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 33689 Alabama

Profile Details

NPI number 1396185666
LBN Legal business name Wallace, Audrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 1st, 2013
Last updated Sep 27th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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