DR. DANA V WALLACE MD

Allergy and Immunology

Ft Lauderdale, Florida

Provider NPI: 1437192531

Provider Information:
DR. DANA V WALLACE MD


Practice Location:
2699 STIRLING RD STE B305  FT LAUDERDALE, FL 33312 US
Tel: 954-981-9180  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	207K00000X	Physicians Allergy & Immunology	FL	ME0025502

Other Provider Identifiers:

Issuer	Number	State	Type
MEDICARE	93292X	FL	01
	006256200	FL	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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