Wallace, Tasha B
Wallace, Tasha B is an individual health care provider with primary practice located at 14651 Palm Beach Blvd Ste 100 , Fort Myers FL 33905-2331. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wallace, Tasha B can be contacted via phone (239) 369-2903.Contact Information
Primary practice address
14651 Palm Beach Blvd Ste 100
Fort Myers FL 33905-2331
Phone: (239) 369-2903
Fax: (239) 369-0500
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS8622 | Florida |
Profile Details
| NPI number | 1396736997 |
|---|---|
| LBN Legal business name | Wallace, Tasha B |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Aug 27th, 2024 - about 2 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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