Wallace, Kevin H
Wallace, Kevin H is an sole proprietor health care provider with primary practice located at 1350 Hickory St , Melbourne FL 32901-3224. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Wallace, Kevin H can be contacted via phone (321) 434-4225.Contact Information
Primary practice address
1350 Hickory St
Melbourne FL 32901-3224
Phone: (321) 434-4225
Fax: (321) 434-4247
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | ME81186 | Florida |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | ME81186 | Florida |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME81186 | Florida |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | ME81186 | Florida |
Profile Details
| NPI number | 1033195631 |
|---|---|
| LBN Legal business name | Wallace, Kevin H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 16th, 2005 |
| Last updated | Aug 26th, 2022 - 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 | 1033195631 | NPPES |
| Florida | MEDICAID | 014488700 |
Popular Providers
-
Spero, Kerry Elizabeth
2329 Medico Ln Ste 101 , Melbourne FL 32940-8449 -
Wheeler, Mark Lyle
1223 Gateway Dr Ste 2G , Melbourne FL 32901-2607 -
Ortega, Ismael
1223 Gateway Dr Ste 2G , Melbourne FL 32901-2607 -
Stall, Homer Phillips
200 E Sheridan Rd , Melbourne FL 32901-3142 -
Amgott, Theodore R
1223 Gateway Dr Ste 2F , Melbourne FL 32901-2607 -
Koshy, Arun
1223 Gateway Dr Suite 2F, Melbourne FL 32901-2607 -
Mazahir, Usman
1314 Oak St , Melbourne FL 32901-3111 -
Pinto, Simmy Jerry
402 N Babcock St Suite 402, Melbourne FL 32935-7335