DR. ROBERT JENNINGS WALLACE


Address: 3000 1st Ave N, St Petersburg, FL 33713-8607
Phone: 7278260700

DR. ROBERT JENNINGS WALLACE (NPI# 1821396151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821396151
Entity Type Individual
Full Name DR. ROBERT JENNINGS WALLACE
Credential MD
Practice Address 3000 1st Ave N
St Petersburg
FL 33713-8607
Practice Telephone 7278260700
Practice Fax Number 7279546994
Mailing Telephone 7278260700
Mailing Fax Number 7279546994
Enumeration Date 2011-03-10
Last Update Date 2018-03-17
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0505X Family Medicine
Specialization: Adult Medicine
ME 42522 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 014630900 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
721 Dr Martin Luther King Jr St S, St Petersburg, FL 337051922 7272281650 7279546994

Other Providers ROBERT WALLACE

NPI Name Taxonomy Address Enumeration
1316430176 Robert E Wallace Case Manager/Care Coordinator 283 Old Colliers Way, Weirton, WV 26062-4073 2018-06-07
1801337134 Robert William Wallace II Student in an Organized Health Care Education/Training Program 204 N Silver Maple Dr, Slidell, LA 70458-5483 2017-03-20
1780015610 Robert G. Wallace Radiology 1130 Goat Rock Road, Fortson, GA 31808 2013-12-03
1972947257 Robert William Wallace Registered Nurse 40 Ridge Dr, West Hurley, NY 12491-5627 2013-04-17
1487991683 Robert J Wallace Acupuncturist 1619 W Montrose, Chicago Holistic Medicine, Chicago, IL 60613 2013-01-08
1154582773 Robert Lee Wallace Counselor 110 S Hancock St, Rockingham, NC 28379-3675 2008-06-17
1649484635 Robert Jay Wallace Obstetrics & Gynecology 6250 Alfred Harrell Hwy, Bakersfield, CA 93308-9654 2007-05-09
1023132644 Robert S Wallace Chiropractor 7 Centre Dr, Suite 10, Monroe, NJ 08831-1565 2007-03-19
1750443024 Robert Wallace Pharmacist 12421 W Denton Ave, Litchfield Park, AZ 85340-3435 2006-12-14
1922113174 Robert Vernon Wallace Family Medicine 400 Lee Blvd, Lehigh Acres, FL 33936-4923 2006-08-20

Office Location

Street Address 3000 1ST AVE N
City ST PETERSBURG
State FL
Zip Code 33713-8607

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154371714 Ernst E. Vieux, Jr., M.d., P.a. Surgery 3000 1st Ave N, St Petersburg, FL 33713-8607 2006-05-12
1538799747 Craig F Callam-olaguibel Registered Nurse 3000 1st Ave N, St Petersburg, FL 33713-8607 2020-01-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073122230 Busy Bee Aba Therapy LLC Assistant Behavior Analyst 441 33rd Street North #407, St. Petersburg, FL 33713 2020-07-23
1902428899 Taylor Lorraine Fowler Behavior Technician 7381 114th Ave, Suite 405 Largo Fl 33773, Suite 405, St. Petersburg, FL 33713 2020-05-13
1770120180 Mai Family and Sedation Dentistry, Pa Dentist 495 31st Street North, St. Petersburg, FL 33713 2019-12-04
1932672524 Julie Marlowe Gilbert Dermatology 2191 9th Ave North, Ste. 100, St. Petersburg, FL 33713 2019-01-07
1962992024 Lauren Elizabeth Oloughlin Nurse Practitioner 1001 37th St N Ste C, St Petersburg, FL 33713 2018-05-15
1447766316 Melanie Marie Byrne Assistant Behavior Analyst 5185 45th St N, Bldg C, St. Petersburg, FL 33713 2017-12-14
1942679683 Teresa E Peak Physician Assistant 2191 9th Ave N St 220, St. Petersburg, FL 33713 2015-09-23
1639555204 Priya Panara Internal Medicine 2299 9th Ave N Ste 1f, St Petersburg, FL 33713 2015-08-06
1730568635 Kevin Michael Carbonell Dentist 3863 Central Avenue, Saint Petersburg, FL 33713 2015-05-26
1558752972 Sage Program, LLC Community/Behavioral Health 3530 1st Avenue North, Suite 111, St. Petersbrug, FL 33713 2015-02-06
Find all providers in zip 33713

Taxonomy Information

Taxonomy Code 207QA0505X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Adult Medicine

Taxonomy Definition

Definition to come.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164836797 Pinellas Health & Wellness, LLC Family Medicine 222 2nd St N, St Petersburg, FL 33701-3314 2014-06-11
1306111737 Norval Mason Marr Jr. Family Medicine 501 Coffee Pot Riviera Ne, St Petersburg, FL 33704-3617 2012-03-19
1205036555 K Jean Joviak Md Pa Family Medicine 860 S Village Dr N, 105, St Petersburg, FL 33716-3024 2007-07-24
1932298411 Margaret Teresa Nusca Family Medicine 690 4th Ave S, St Petersburg, FL 33701 2006-10-12
1851344485 John E Kern Family Medicine 5838 9th Ave N, St Petersburg, FL 33710-6319 2006-05-17
1811498652 Tampa Bay Hospitalists LLC Family Medicine 1839 Central Ave, St Petersburg, FL 33713-8900 2018-02-27
1932598349 Clear Path Center Pa Family Medicine 3177 4th St N, St Petersburg, FL 33704-2124 2015-01-22
1427394303 Capital Medical Group, LLC Family Medicine 5985 49th St N, St Petersburg, FL 33709-2111 2012-12-20
1003116625 John E Kern Do Pa Family Medicine 5838 9th Ave N, St Petersburg, FL 33710-6319 2010-10-29
1760625099 Gregory W. Nestor, Md, LLC Family Medicine 7655 38th Ave N, Suite 202, St Petersburg, FL 33710-1263 2009-04-16
Find all providers in ST PETERSBURG

Competitor

Search similar providers

City ST PETERSBURG
Zip Code 33713

Improve Information

Please comment or provide details below to improve the information on DR. ROBERT JENNINGS WALLACE.

Dataset Information

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.

Trending Searches