Wallace, Danielle Charisse
Wallace, Danielle Charisse is an individual health care provider with primary practice located at 1801 Lee Rd Ste 165 , Winter Park FL 32789. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wallace, Danielle Charisse can be contacted via phone (407) 975-0410.Contact Information
Primary practice address
1801 Lee Rd Ste 165
Winter Park FL 32789
Phone: (407) 975-0410
Fax: (407) 975-0413
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD61340360 | Washington |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME129213 | Florida |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 8023169-1205 | Utah |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 4301088447 | Michigan |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | U0741 | Texas |
Profile Details
| NPI number | 1114147006 |
|---|---|
| LBN Legal business name | Wallace, Danielle Charisse |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2007 |
| Last updated | Jun 13th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114147006 | NPPES |
| Washington | MEDICAID | 2231891 |
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