| Jennifer Lea Wallace, PAC | |
|
625 6th Ave S, Suite 385, Saint Petersburg, FL 33701-4662 | |
| (727) 553-7100 | |
| (727) 553-7198 |
| Full Name | Jennifer Lea Wallace |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 625 6th Ave S, Saint Petersburg, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700864493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA9105134 (Florida) | Primary |
| 363AS0400X | Physician Assistant - Surgical | PA9105134 (Florida) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Lea Wallace, PAC 625 6th Ave S, Suite 385, Saint Petersburg, FL 33701-4662 Ph: (727) 553-7100 | Jennifer Lea Wallace, PAC 625 6th Ave S, Suite 385, Saint Petersburg, FL 33701-4662 Ph: (727) 553-7100 |
Fallon Lanham, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 601 5th St S Ste 302, Saint Petersburg, FL 33701 Phone: 813-505-2377 Fax: 813-200-3491 | |
Sherill Albert, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2345 14th St N, Saint Petersburg, FL 33704 Phone: 727-954-0295 | |
Danilo Enrique Soto Leon, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1651 Massachusetts Ave Ne, Saint Petersburg, FL 33703 Phone: 305-497-5442 | |
Brianna Taylor Emmrich, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5398 Park St N, Saint Petersburg, FL 33709 Phone: 727-544-1441 | |
Emily Earle Lenhardt, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2299 9th Ave N, Suite 3b, Saint Petersburg, FL 33713 Phone: 727-321-3344 Fax: 727-321-3236 | |
Lorenna Lynn Guerra, CFA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 603 7th St S Ste 300, Saint Petersburg, FL 33701 Phone: 727-954-7121 Fax: 727-954-7123 | |
Koren Schram, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 12000 4th St N, Apt 612, Saint Petersburg, FL 33716 Phone: 603-359-0698 |