John D Wallace, is a
Homemaker based in Miami, Florida. John D Wallace is licensed to practice in Florida (license number 235276) and his current practice location is
1455 Nw 53rd St Apt 222, Miami, Florida. He can be reached at his office (for appointments etc.) via phone at
(904) 418-3893.
NPI number for John D Wallace is 1679900161 and his current mailing address is 15286 Sw 104th St Apt 2-22, Miami, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679900161.
Healthcare Provider's Profile
| Full Name | John D Wallace |
|---|
| Gender | Male |
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| Speciality | Homemaker |
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| Location | 1455 Nw 53rd St Apt 222, Miami, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1679900161
- Provider Enumeration Date: 09/30/2013
- Last Update Date: 06/29/2018
Medical Identifiers
Medical identifiers for John D Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679900161 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 385H00000X | Respite Care | 235276 (Florida) | Secondary |
| 376J00000X | Homemaker | 235276 (Florida) | Primary |
| 372600000X | Adult Companion | 235276 (Florida) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John D Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
John D Wallace,
15286 Sw 104th St Apt 2-22,
Miami, FL 33196-3238
Ph: (904) 418-3893 | John D Wallace,
1455 Nw 53rd St Apt 222,
Miami, FL 33142
Ph: (904) 418-3893 |
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