Mrs Cynthia Catherine Wallace, PA is a medicare enrolled "Physician Assistant - Surgical" physician in Vero Beach, Florida. Her current practice location is
5070 Highway A1a Ste A, Vero Beach, Florida. You can reach out to her office (for appointments etc.) via phone at
(954) 531-9433.
Mrs Cynthia Catherine Wallace is licensed to practice in Florida (license number PA9114207) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1730596875.
Physician's Profile
Full Name | Mrs Cynthia Catherine Wallace |
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Gender | Female |
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Speciality | Physician Assistant - Surgical |
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Location | 5070 Highway A1a Ste A, Vero Beach, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1730596875
- Provider Enumeration Date: 07/21/2014
- Last Update Date: 04/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 8123331378
- Enrollment ID: I20150717000923
Medical Identifiers
Medical identifiers for Mrs Cynthia Catherine Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1730596875 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | C0005406 (Maryland) | Secondary |
363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
363AS0400X | Physician Assistant - Surgical | PA9114207 (Florida) | Primary |
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. Mrs Cynthia Catherine Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Cynthia Catherine Wallace, PA 5070 Highway A1a Ste A, Vero Beach, FL 32963-1229 Ph: (954) 531-9433 | Mrs Cynthia Catherine Wallace, PA 5070 Highway A1a Ste A, Vero Beach, FL 32963-1229 Ph: (954) 531-9433 |
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