Tasha B Wallace in Fort Myers - Family Medicine
Tasha B Wallace - NPI 1396736997
Tasha B Wallace is a Family Medicine in Fort Myers, Florida. Tasha B Wallace practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Tasha B Wallace is 1396736997. The last update date is 2022-06-16.
Tasha B Wallace's current location address is 14651 Palm Beach Blvd Ste 100, Fort Myers, Florida. You can contact this provider via phone number 2393692903 and fax number 2393690500. The mailing address for Tasha B Wallace is 14651 Palm Beach Blvd Ste 100, Fort Myers, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tasha B Wallace |
|---|---|
| Address | 14651 Palm Beach Blvd Ste 100, Fort Myers, Florida |
| Phone Number | 2393692903 |
| Fax Number | 2393690500 |
| Sole Proprietor | N |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1396736997 |
|---|---|
| Provider Enumeration Date | 2005-11-02 |
| Last Updated Date | 2022-06-16 |
Provider Mailing Address Detail
| Address | 14651 Palm Beach Blvd Ste 100 |
|---|---|
| City | Fort Myers |
| State | Florida (FL) |
| Post Code | 339052331 |
| Phone Number | 2393692903 |
| Fax Number | 2393690500 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | OS8622 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Post Comment/ Review Below
What is the unique identifier code issued to Tasha B Wallace by the Centers for Medicare & Medicaid Services (CMS)?
The Tasha B Wallace has been assigned the NPI (National Provider Identifier) 1396736997. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Tasha B Wallace?
The Tasha B Wallace is situated at 14651 Palm Beach Blvd Ste 100, in the city of Fort Myers, state of FL, with the zip code 339052331.
What is Tasha B Wallace's specialized field of practice, and what is the corresponding taxonomy classification code?
The Tasha B Wallace's area of specialization is Family Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Q00000X.
On what date did the Tasha B Wallace receive its 1396736997 assignment from the Centers for Medicare & Medicaid Services?
The Tasha B Wallace was assigned its 1396736997 by the Centers for Medicare & Medicaid Services on 2005-11-02.
As of what date was the information regarding Tasha B Wallace, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Tasha B Wallace, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2022-06-16.