Wallace, Jordan
Wallace, Jordan is an individual health care provider with primary practice located at 9981 S Healthpark Dr , Fort Myers FL 33908-3618. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as her primary health care specialty. Wallace, Jordan can be contacted via phone (239) 343-9163.Contact Information
Primary practice address
9981 S Healthpark Dr
Fort Myers FL 33908-3618
Phone: (239) 343-9163
Fax: (239) 343-5321
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 9725 | Florida |
Profile Details
| NPI number | 1790538015 |
|---|---|
| LBN Legal business name | Wallace, Jordan |
| Credentials | PHARMD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2024 |
| Last updated | Apr 8th, 2024 - about last year |
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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