Wallace, Dana V

Wallace, Dana V is an sole proprietor health care provider with primary practice located at 2699 Stirling Rd Ste B305 , Ft Lauderdale FL 33312-6546. She recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as her primary health care specialty. Wallace, Dana V can be contacted via phone (954) 981-9180.

Contact Information

Primary practice address
2699 Stirling Rd Ste B305 Ft Lauderdale FL 33312-6546
Phone: (954) 981-9180
Fax: (954) 961-4752
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X ME0025502 Florida

Profile Details

NPI number 1437192531
LBN Legal business name Wallace, Dana V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Jul 21st, 2022 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1437192531 NPPES
Florida MEDICAID 006256200
Florida Other 93292X

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