EVELINE WALLACE (NPI# 1427058932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427058932 |
| Entity Type | Individual |
| Full Name | EVELINE WALLACE |
| Credential | ARNP |
| Practice Address |
2415 N Orange Ave Suite # 700 Orlando FL 32804-5505 |
| Practice Telephone | 4073037171 |
| Practice Fax Number | 4073037195 |
| Mailing Telephone | 4073037171 |
| Mailing Fax Number | 4073037195 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2012-02-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
1728202 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | P00360116 | 01 |
| Street Address |
2415 N ORANGE AVE SUITE # 700 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32804-5505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962401331 | Nirav Y. Raval | Internal Medicine | 2415 N Orange Ave, Suite 600, Orlando, FL 32804-5505 | 2005-07-19 |
| 1356875819 | Damian Korsich | Student in an Organized Health Care Education/Training Program | 2415 N Orange Ave, Suite 400, Orlando, FL 32804-5505 | 2017-04-11 |
| 1710342803 | Jeffrey T Johnson | Nurse Practitioner | 2415 N Orange Ave, Suite 700, Orlando, FL 32804-5505 | 2015-12-16 |
| 1265817431 | Daniel Figueroa Tentori | Surgery | 2415 N Orange Ave, Suite 400, Orlando, FL 32804-5505 | 2015-07-29 |
| 1942605027 | Sarah Souverain | Nurse Practitioner | 2415 N Orange Ave, Suite 502, Orlando, FL 32804-5505 | 2014-10-30 |
| 1477957934 | Elidalis R Burgos | Nurse Practitioner | 2415 N Orange Ave, 700, Orlando, FL 32804-5505 | 2014-10-13 |
| 1932520111 | Amber Nicole Brennan | Nurse Practitioner | 2415 N Orange Ave, Suite 700, Orlando, FL 32804-5505 | 2013-12-14 |
| 1346529716 | Jeffrey Chiu | Surgery | 2415 N Orange Ave, Suite 400, Orlando, FL 32804-5505 | 2011-08-16 |
| 1043507825 | Hea Lyoung Lee | Nurse Practitioner | 2415 N Orange Ave, 700, Orlando, FL 32804-5505 | 2011-06-30 |
| 1134446313 | Frances K Smith | Dietitian, Registered | 2415 N Orange Ave, Suite # 700, Orlando, FL 32804-4603 | 2010-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881252716 | Alyssa Bass | Counselor | 3130 Edgewater Dr, Orlando, FL 32804 | 2019-06-05 |
| 1841856366 | Debora Cheryl Ramirez | Technician/Technologist | 1231 North Orange Ave, Orlando, FL 32804 | 2019-05-10 |
| 1679074009 | Jessica Dobbs | Counselor | 3801 Grant Blvd, Orlando, FL 32804 | 2018-02-21 |
| 1881109031 | Pedro Mendez Jr. | Counselor | 1800 W. Colonial Drive, Orlando, FL 32804 | 2017-12-11 |
| 1902259310 | Michael Lo | Nurse Practitioner | 2400 N Orange Ave Ste 302, Orlando, FL 32804 | 2016-07-20 |
| 1083093595 | Michael Gregg | Student in an Organized Health Care Education/Training Program | 2415 North Orange Avenue, Suite 400, Orlando, FL 32804 | 2015-05-29 |
| 1922485473 | Lindsay Rae Piet | Physician Assistant | 1910 N. Orange Ave., Orlando, FL 32804 | 2015-05-05 |
| 1093106189 | College Park Community Acupuncture & Herbal Medicine | Acupuncturist | 710 W. Princeton Street., Suite A, Orlando, FL 32804 | 2015-02-10 |
| 1164822359 | Orlando Sleep Solutions, LLC | Durable Medical Equipment & Medical Supplies | 2921 N. Orange Ave, Orlando, FL 32804 | 2014-08-26 |
| 1780926741 | Joseph Arturo Reza | Student in an Organized Health Care Education/Training Program | 2415 N Orange Ave #400, Orlando, FL 32804 | 2013-03-17 |
| Find all providers in zip 32804 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770100828 | Dana Santiago | Nurse Practitioner | 3110 Lake Jean Dr, Orlando, FL 32817-2324 | 2020-07-06 |
| 1609496629 | Autumn Nicole Walker | Nurse Practitioner | 2811 Ripton Ct, Orlando, FL 32835-6147 | 2020-04-20 |
| 1366913121 | Heather Freeman | Nurse Practitioner | 1400 S Orange Ave # Mp700, Orlando, FL 32806-2134 | 2018-12-05 |
| 1114403631 | Millian Okafor | Nurse Practitioner | 14918 Faberge Dr, Orlando, FL 32828-5118 | 2018-07-17 |
| 1134663933 | Marian Coppo Chase | Nurse Practitioner | 801 Vassar St, Orlando, FL 32804-4922 | 2016-12-13 |
| 1306291372 | Carlos Ivan Sanchez | Nurse Practitioner | 8012 Prestbury Dr, Orlando, FL 32832-6306 | 2016-04-27 |
| 1467831040 | Mary Philip | Nurse Practitioner | 13203 Chattanooga Ln, Orlando, FL 32837-4005 | 2015-05-28 |
| 1114325529 | Lola M Ortega | Nurse Practitioner | 1115 East Ridgewood Street, Orlando, FL 32803-6947 | 2014-12-17 |
| 1689090276 | Amina Hussain Ali | Nurse Practitioner | 6983 Brescia Way, Orlando, FL 32819-5269 | 2014-03-06 |
| 1447690870 | Rebecca Lee Ritz | Nurse Practitioner | 2111 Crosshair Cir, Orlando, FL 32837-7408 | 2013-06-30 |
| Find all providers in ORLANDO | ||||
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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.