Dr. Danielle Charisse Wallace
M.D. | Pediatrics | Female
Dr. Danielle Charisse Wallace, M.D. is a Winter Park, Florida based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Danielle Charisse Wallace is
1801 Lee Rd Ste 165, Winter Park, Florida - 32789. She can be contacted on phone at
407-975-0410 and fax number 407-975-0413.
Dr. Danielle Charisse Wallace is a sole proprietor of her business.
NPI number (Unique professional ID) for Dr. Danielle Charisse Wallace is
1114147006 which was assigned by NPPES on 26 Apr, 2007 and it was last updated on 05 Apr, 2023.
Dr. Danielle Charisse Wallace license number is
ME129213 for Pediatrics (208000000X) in Florida.
Dr. Danielle Charisse Wallace is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Danielle Charisse Wallace basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Dr. Danielle Charisse Wallace |
|---|
| Credential : | M.D. |
|---|
| Gender : | Female |
|---|
Business Address:
Dr. Danielle Charisse Wallace address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1801 Lee Rd Ste 165
Winter Park, FL, 32789
United States |
|---|
| Phone Number : | 407-975-0410 |
|---|
| Fax Number : | 407-975-0413 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1114147006 |
|---|
| NPI Entity Type : | Individual |
|---|
| First Enrolment Date : | 26 Apr, 2007 |
|---|
| Last Updated On : | 05 Apr, 2023 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Danielle Charisse Wallace are as mentioned. Primary taxonomy code for Dr. Danielle Charisse Wallace, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | MD61340360 | WA |
| 208000000X | Pediatrics | No | 8023169-1205 | UT |
| 208000000X | Pediatrics | Yes | ME129213 | FL |
| 208000000X | Pediatrics | No | 4301088447 | MI |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Danielle Charisse Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 2231891 | MEDICAID | WA | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
1627 S 3050 W,
VERNAL, UT, 84078-8719
United States | VERNAL, UT | 616-717-3171 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1801 Lee Rd Ste 165
Winter Park, FL, 32789-2127
United States |
|---|
| Phone Number : | 407-975-0410 |
|---|
| Fax Number : | 407-975-0413 |
|---|
Business Location:
Patients can refer following map for directions to
Dr. Danielle Charisse Wallace practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.