JOCELYN DIANE WALLACE (NPI# 1154845600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154845600 |
| Entity Type | Individual |
| Full Name | JOCELYN DIANE WALLACE |
| Credential | PT, DPT |
| Practice Address |
1830 Radius Dr Apt 910 Hollywood FL 33020-7716 |
| Practice Telephone | 8134079004 |
| Mailing Telephone | 8134079004 |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2020-01-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851715171 | Jocelyn Jones Wallace | Counselor | 1203 Kent Rd, Raleigh, NC 27606-1977 | 2014-02-06 |
| Street Address |
1830 RADIUS DR APT 910 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33020-7716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407335268 | Wallace Physical Therapy LLC | Clinic/Center | 1830 Radius Dr Apt 910, Hollywood, FL 33020-7716 | 2018-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694203 | Oaks Medical Group, LLC | Internal Medicine | 2854 Jackson St, Hollywood, FL 33020 | 2020-06-19 |
| 1487217949 | Yaneisy Correa Vento Sr. | Nurse Practitioner | 2700 E Hollywood Blud, Hollywood, FL 33020 | 2019-04-19 |
| 1811453590 | Sandra's Car Service LLC | Non-emergency Medical Transport (VAN) | 2048 Mckinley St. Bay #1, Hollywood, FL 33020 | 2019-02-18 |
| 1134605330 | Cruz Ines Diaz | Peer Specialist | 3400 N- 29th Avenue, Hollywood, FL 33020 | 2018-07-11 |
| 1598258451 | Brian Tran | Dentist | 1704 Stirling Rd., Hollywood, FL 33020 | 2018-06-14 |
| 1295223451 | Broward Treatment Center | Substance Abuse Rehabilitation Facility | 1101 S 21 Ave, Hollywood, FL 33020 | 2018-04-24 |
| 1033617220 | Laura Goldman | Psychologist | 2514 Hollywood Blvd Ste 404, Hollywood, FL 33020 | 2018-01-23 |
| 1205344835 | Sunshine Health Supplies LLC | Durable Medical Equipment & Medical Supplies | 1926 Hollywood Blvd Ste 204, Hollywood, FL 33020 | 2018-01-17 |
| 1124536222 | Melina Rodriguez | Counselor | 3400 N 29th Avenue, Hollywood, FL 33020 | 2018-01-11 |
| 1003337783 | Publix Super Markers, Inc | Durable Medical Equipment & Medical Supplies | 1776 Polk St., Hollywood, FL 33020 | 2017-07-03 |
| Find all providers in zip 33020 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952872475 | Pablo Vega | Physical Therapist | 3325 Hollywood Blvd Ste 200, Hollywood, FL 33021-6926 | 2018-12-10 |
| 1760634356 | Archer Physical Therapy and Pilates Institute Inc | Physical Therapist | 2450 Hollywood Blvd Ste 301b, Hollywood, FL 33020-6642 | 2008-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422064 | Purpose Physical Therapy and Wellness, LLC | Physical Therapist | 3369 10th St N, St Petersburg, FL 33704-1205 | 2020-09-16 |
| 1114532074 | Rezalo Health & Performance | Physical Therapist | 27402 Bonterra Loop Apt 401, Wesley Chapel, FL 33544-5165 | 2020-09-08 |
| 1578173217 | Katherine Herzfeld | Physical Therapist | 2954 Mallory Cir Ste 110, Celebration, FL 34747-1820 | 2020-08-07 |
| 1447875331 | Janelle Marie Fleites | Physical Therapist | 6190 Sw 116th St, Pinecrest, FL 33156-4957 | 2020-06-16 |
| 1154944155 | University of Central Florida | Physical Therapist | 4098 Libra Dr Ste 114, Orlando, FL 32816-8026 | 2020-05-26 |
| 1164044590 | Prestige Health & Performance | Physical Therapist | 20354 Chestnut Grove Dr, Tampa, FL 33647-3344 | 2020-05-07 |
| 1295356491 | Complex Somi LLC | Physical Therapist | 5829 Sw 73rd St Ste 2, South Miami, FL 33143-5276 | 2020-04-29 |
| 1952939043 | Fix It Physical Therapy, LLC | Physical Therapist | 8262 Griffin Rd, Davie, FL 33328-3715 | 2020-04-01 |
| 1649806449 | Korbin Joseph Keene | Physical Therapist | 1053 Medical Center Dr Ste 151, Orange City, FL 32763-8261 | 2020-03-13 |
| 1740814391 | Jessy Chang | Physical Therapist | 8615 S Tamiami Trl # 1, Sarasota, FL 34238-3052 | 2020-02-22 |
| Find all providers with the same taxonomy | ||||
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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.