MR. STEVEN GREGORY WALLACE JR. (NPI# 1851713952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851713952 |
| Entity Type | Individual |
| Full Name | MR. STEVEN GREGORY WALLACE JR. |
| Credential | PA |
| Practice Address |
511 W Alexander St Plant City FL 33563-7116 |
| Mailing Address |
5026 Fairfax Dr Lakeland FL 33813-2917 |
| Practice Telephone | 8136599800 |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PAT9107761 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649779950 | Steven Mark Wallace | Massage Therapist | 1001 W. Oak St. Bldg C. Ste. 210, Bozeman, MT 59715 | 2018-02-02 |
| 1073029864 | Steven E Wallace | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2017-12-16 |
| 1922461847 | Steven James Wallace | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2016-03-29 |
| 1457515587 | Steven Earl Wallace | Specialist/Technologist, Other | 1065 Bucks Lake Rd, Quincy, CA 95971-9507 | 2008-07-17 |
| 1114986551 | Steven F. Wallace | Pediatrics | 4545 Cordata Pkwy, Bellingham, WA 98226-7123 | 2006-03-23 |
| Street Address |
511 W ALEXANDER ST |
| City | PLANT CITY |
| State | FL |
| Zip Code | 33563-7116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215909262 | Timothy B Williams | Pediatrics | 511 W Alexander St, Suite 2, Plant City, FL 33563-7116 | 2006-02-03 |
| 1194051623 | Charles Ross Md Pa | Family Medicine | 511 W Alexander St, Suite 1, Plant City, FL 33563-7116 | 2009-10-17 |
| 1306074422 | Anthony Carl Marcket | Physical Therapist | 511 W Alexander St, Plant City, FL 33563-7116 | 2009-06-26 |
| 1437185444 | Sandhill Bone & Joint Inc | Orthopaedic Surgery | 511 W Alexander St, Plant City, FL 33563 | 2006-06-23 |
| 1821065061 | Chandra Robinson Williams | Pediatrics | 511 W Alexander St, Suite 2, Plant City, FL 33563-7116 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738063 | Selena Giordano | Counselor | 1001 East Baker Street #100, Plant City, FL 33563 | 2020-10-22 |
| 1275171787 | Mary Ann Dillon | Nutritionist | 2011 N Wheeler Street, Plant City, FL 33563 | 2019-12-16 |
| 1023504271 | Florida Family Primary Care Centers of Tampa, LLC | Pediatrics | 1608 Oak Ave, Plant City, FL 33563 | 2018-07-10 |
| 1770092215 | Jennifer Lauren Zeljkovic | Nurse Practitioner | 1703 W. Thonotosassa Rd. A, Plant City, FL 33563 | 2017-09-27 |
| 1831632116 | Nusrat Bangash | Nurse Practitioner | 306 W Dixie St, Plant City, FL 33563 | 2016-11-18 |
| 1265987416 | Genice Collins Davis | Counselor | Heads, 100 E Baker Street #100, Plant City, FL 33563 | 2016-08-17 |
| 1184017089 | The Creative Chance | Counselor | 1803 C Collins Common James Redman Parkway, Plant City, FL 33563 | 2015-03-17 |
| 1518361377 | Anne J Lafontant | General Practice | 1509 W. Reynolds St Jay Care Medical Center, Plant City, FL 33563 | 2014-10-22 |
| 1003160201 | Heritage View Alf Inc. | Assisted Living Facility | 104 N. Gordon Street, Tampa, FL 33563 | 2012-11-09 |
| 1841455607 | Darshan Bhupen Shah | Family Medicine | 301 North Alexander Street, Advanced Care Hospitalists, Plant City, FL 33563 | 2008-07-22 |
| Find all providers in zip 33563 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992360119 | Celeste Mariah Echevarria | Physician Assistant | 3124 Azalea Blossom Dr, Plant City, FL 33567-2105 | 2019-05-02 |
| 1255620100 | Megan Erin Mcgee | Physician Assistant | 3312 Nohlcrest Pl, Plant City, FL 33566-0729 | 2011-03-31 |
| 1578668620 | Thomas W Wildes | Physician Assistant | 110 Southern Oaks Dr, Plant City, FL 33563-1446 | 2006-09-13 |
| 1508884461 | Jennifer Rae Gerges | Physician Assistant | 508 N Maryland Ave., Plant City Family Care, Plant City, FL 33563 | 2006-07-18 |
| 1215953674 | Kristin Marie Dupre | Physician Assistant | 802 W Mlk Blvd, Plant City, FL 33563-5105 | 2006-07-15 |
| 1841781010 | Melissa Carolina Nunez | Physician Assistant | 228 W Alexander St, Plant City, FL 33563 | 2018-05-23 |
| 1184071938 | Alyssa Cobb | Physician Assistant | 3065 James L Redman Pkwy, Plant City, FL 33566 | 2016-05-23 |
| 1073971172 | Top Tier Emergency Physicians, LLC | Physician Assistant | 3065 James L Redman Pkwy, Plant City, FL 33566-9400 | 2016-02-03 |
| 1508275447 | Rainier Emergency Physicians LLC | Physician Assistant | 3065 James L Redman Pkwy, Plant City, FL 33566-9400 | 2014-08-05 |
| 1225384878 | Kristin L Riley | Physician Assistant | 615 E Alexander St, Plant City, FL 33563-7126 | 2012-08-01 |
| Find all providers in PLANT CITY | ||||
| City | PLANT CITY |
| Zip Code | 33563 |
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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.