DR. DOUGLAS MCKAY WALLACE (NPI# 1013058932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013058932 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS MCKAY WALLACE |
| Credential | MD |
| Practice Address |
1201 Nw 16th St Miami Va Medical Center, Dept of Neurology Miami FL 33125-1624 |
| Mailing Address |
11104 Sw 139th Ct Miami FL 33186-3251 |
| Practice Telephone | 3055757000 |
| Mailing Telephone | 3053877346 |
| Mailing Fax Number | 3053874632 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME94643 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376698753 | Douglas W. Wallace | Oral & Maxillofacial Surgery | 5188 Winton Rd, Fairfield, OH 45014-2900 | 2007-01-24 |
| 1063451144 | Douglas C Wallace | Family Medicine | 3154 Park St, Grove City, OH 43123-3222 | 2006-06-05 |
| 1730794041 | Douglas Wallace | Hearing Instrument Specialist | 95 Post Office Park, Wilbraham, MA 01095-1248 | 2020-09-14 |
| 1285098806 | Douglas Wallace | Emergency Medicine | 625 19th St S, Birmingham, AL 35233 | 2016-04-09 |
| 1811181498 | Douglas Cecil Wallace | Medical Genetics, Ph.D. Medical Genetics | 2014 Hewitt Hall, University of California Irvine, Irvine, CA 92697-3940 | 2007-08-28 |
| 1851470033 | Douglas Charles Wallace | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3900 St Francis Way, Ste 201, Lafayette, IN 47905-4923 | 2006-11-06 |
| 1881657989 | Douglas M Wallace | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2006-04-10 |
| 1083608053 | Douglas W Wallace | Radiology | 2300 Manchester Expy, Ste A001, Columbus, GA 31904-6802 | 2005-09-07 |
| Street Address |
1201 NW 16TH ST MIAMI VA MEDICAL CENTER, DEPT OF NEUROLOGY |
| City | MIAMI |
| State | FL |
| Zip Code | 33125-1624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063415727 | Angel Colon-molero | Internal Medicine | 1201 Nw 16th St, (11em), Miami, FL 33125-1624 | 2005-05-24 |
| 1386241602 | Lyn Paulo Juarez | Registered Nurse | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-10-09 |
| 1578161808 | James Clayman | Registered Nurse | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-10-09 |
| 1679170559 | Marbelly Daniela Rosales | Registered Nurse | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-10-05 |
| 1023615903 | Alejandra Martinez | Registered Nurse | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-10-05 |
| 1205449139 | Claire Gelin | Pharmacist | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-08-29 |
| 1669085999 | Latiffa Denise Reed | Social Worker | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-08-26 |
| 1558972950 | Dara J Shapiro | Psychologist | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-08-11 |
| 1376153015 | Zuleika Smith | Recreation Therapist | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-08-07 |
| 1548879026 | Jessica M Bryant | Psychologist | 1201 Nw 16th St, Miami, FL 33125-1624 | 2020-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912469 | Loves Community Mental Health Inc | Clinic/Center | 2 Nw 30th Ave, Miami, FL 33125 | 2020-11-03 |
| 1548872971 | Easter Seals South Florida, Inc. | Home Health | 1475 Nw 14 Ave, Miami, FL 33125 | 2020-08-18 |
| 1295368991 | Stellar Alf II LLC | Assisted Living Facility | 3055 N.w. Flagler Terr., Miami, FL 33125 | 2020-02-20 |
| 1841773546 | Enmanuel Alejandro Iglesias | Speech-Language Pathologist | Thera-pro Care,llc 888 Nw 27 Avenue, Suite 5, Miami, FL 33125 | 2018-09-10 |
| 1588158117 | Josefina Cammarano De Casas | Behavior Technician | 720 Nw 19th Ct., Miami, FL 33125 | 2018-06-18 |
| 1861984262 | Patricia Gabbidon | Audiologist | 1201 Nw 16th St Rm 2a151, Miami, FL 33125 | 2018-05-31 |
| 1154829471 | Iviana Tamara Farinas | Nurse Practitioner | 1951 Nw 7th Street, Miami, FL 33125 | 2018-02-01 |
| 1316452634 | Dayana A Perez Del Pozo | Physical Therapy Assistant | 1422 Nw 7th Street, Marlins Park Third Base Entrance, Miami, FL 33125 | 2017-12-08 |
| 1275046831 | Galaxy Wellness Sport and Rehabilitation Center LLC | Orthopaedic Surgery | 1951 Nw 7th St, Miami, FL 33125 | 2017-11-06 |
| 1609398247 | Yaremi Ramirez | Behavioral Analyst | 2145 Nw 13th St, Miami, FL 33125 | 2017-07-14 |
| Find all providers in zip 33125 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194293324 | Novel Clinical Research Center, LLC | Psychiatry & Neurology | 9000 Sw 137th Ave Ste 211, Miami, FL 33186-1436 | 2018-11-06 |
| 1245722974 | Alex Sabo Do Pa | Psychiatry & Neurology | 1900 N Bayshore Dr Apt 4508, Miami, FL 33132-3025 | 2018-05-30 |
| 1407392194 | Sarah Hughes | Psychiatry & Neurology | 1421 Sw 82nd Ct, Miami, FL 33144-5245 | 2017-01-18 |
| 1801147574 | Neurology and Wellness Center, Inc | Psychiatry & Neurology | 2433 Sw 147th Ave, Miami, FL 33185-4082 | 2012-09-21 |
| 1750672226 | Lindsay Anne Dudeck | Psychiatry & Neurology | 1150 Nw 14th St Suite 207, Miami, FL 33136-2342 | 2011-05-02 |
| 1275847808 | Gelasio Alberto Baras Pier | Psychiatry & Neurology | 11760 Sw 40th St Ste 502, Miami, FL 33175 | 2010-08-06 |
| 1578874657 | Puja Appasaheb Naik | Psychiatry & Neurology | 475 Brickell Ave Apt 5109, Miami, FL 33131-2714 | 2010-06-23 |
| 1477795813 | Joaquin Salustino Maury Ochoa | Psychiatry & Neurology | 8200 Sw 117th Ave Ste 416, Miami, FL 33183-4828 | 2009-03-31 |
| 1124260773 | Mohan Kottapally | Psychiatry & Neurology | 1120 Nw 14th St Fl 13, Ste. 1358, Miami, FL 33136-2107 | 2009-03-28 |
| 1982878815 | Naymee J Velez-ruiz | Psychiatry & Neurology | 1150 Nw 14th Street, Miami, FL 33136-3612 | 2008-04-22 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.