Wallace, Gabrielle

Wallace, Gabrielle is an sole proprietor health care provider with primary practice located at 3601 W Commercial Blvd Ste 4/5, Fort Lauderdale FL 33309-3300. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Wallace, Gabrielle can be contacted via phone (954) 485-5666.

Contact Information

Primary practice address
3601 W Commercial Blvd Ste 4/5 Fort Lauderdale FL 33309-3300
Phone: (954) 485-5666
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP9287991 Florida

Profile Details

NPI number 1336599026
LBN Legal business name Wallace, Gabrielle
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2016
Last updated Oct 24th, 2016 - about 10 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 1336599026 NPPES
Florida MEDICAID 017754300

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