Wallace, Minda

Wallace, Minda is an sole proprietor health care provider with primary practice located at 298 S Yonge St , Ormond Beach FL 32174-6264. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wallace, Minda can be contacted via phone (386) 274-7840.

Contact Information

Primary practice address
298 S Yonge St Ormond Beach FL 32174-6264
Phone: (386) 274-7840
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9108697 Florida

Profile Details

NPI number 1164809901
LBN Legal business name Wallace, Minda
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 30th, 2015
Last updated Apr 30th, 2015 - about 10 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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