Michael T Wallace (NPI# 1194029777, PAC ID# 1456514520) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1194029777 |
| PAC ID by PECOS | 1456514520 |
| Professional Enrollment ID | I20120530000230 |
| Full Name | Michael T Wallace |
| Organization Legal Name | FLORIDA DEPARTMENT OF HEALTH |
| Address |
224 Se 24th St Alachua County Health Department Gainesville FL 32641-7516 |
| Phone Number | 3523347916 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3072424282 |
| Number of Group Practice Members | 162 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 521323 | MEMORIAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 15530 Nw Us Hwy 441, Suite 10010, Gainesville, FL 32615 | 3864622542 | FLORIDA DEPARTMENT OF HEALTH |
| 15530 Nw Us Hwy 441, Gainesville, FL 32615 | 3864622542 | FLORIDA DEPARTMENT OF HEALTH |
| 224 Se 24th St, Alachua County Health Department, Gainesville, FL 32641-7516 | 3523347916 | FLORIDA DEPARTMENT OF HEALTH |
| 224 Se 24th St, Gainesville, FL 32641-7516 | 3523347916 | FLORIDA DEPARTMENT OF HEALTH |
| Organization Legal Name | FLORIDA DEPARTMENT OF HEALTH |
| Physicians | 215 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Ghasseminia | Nurse Practitioner | Florida Department of Health | 900 University Blvd N, Suite 606, Jacksonville, FL 32211-5589 |
| George Staben Rust | Family Medicine | Florida Department of Health | 139 12th St, Apalachicola, FL 32320-2110 |
| Stephen Wesley Seitz | Physician Assistant | Florida Department of Health | 224 Se 24th St, Alachua County Health Department, Gainesville, FL 32641-7516 |
| Amaury Diaz | Infectious Disease | Florida Department of Health | 1749 Holt Rd, Auburndale, FL 33823-4635 |
| Louise Awart Lewis | Nurse Practitioner | Florida Department of Health | 851 Ave P, Riviera Beach, FL 33404-7258 |
| Jeena Mathew | Nurse Practitioner | Florida Department of Health | 1805 Hobbs Rd, Auburndale, FL 33823-4644 |
| Dannette I Turner | Nurse Practitioner | Florida Department of Health | 1215 N Peacock Ave, Perry, FL 32347-2117 |
| Liana Sacre | Family Medicine | Florida Department of Health | 1350 Nw14th St, Miami, FL 33125-1609 |
| Hannah Padgett | Registered Dietitian Or Nutrition Professional | Florida Department of Health | 50 High Point Rd, Tavernier, FL 33070-2022 |
| Jose A Diaz Barrientos | General Practice | Florida Department of Health | 209 Se Central Ave, Jasper, FL 32052-6153 |
| Street Address |
224 SE 24TH ST ALACHUA COUNTY HEALTH DEPARTMENT |
| City | GAINESVILLE |
| State | FL |
| Zip | 32641-7516 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen Wesley Seitz | Physician Assistant | Florida Department of Health | 224 Se 24th St, Alachua County Health Department, Gainesville, FL 32641-7516 |
| Ana Maria Acosta | Physician Assistant | Florida Department of Health | 224 Se 24th St, Alachua County Health Department, Gainesville, FL 32641-7516 |
| Isaac Sharoon Gill | Physician Assistant | Florida Department of Health | 224 Se 24th St, Alachua County Health Department, Gainesville, FL 32641-7516 |
| Jessica Himmelberger | Nurse Practitioner | Florida Department of Health | 224 Se 24th St, Alachua County Health Department, Gainesville, FL 32641-7516 |
| City | GAINESVILLE |
| Zip Code | 32641 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GAINESVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Michael T Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.