Azel Wallock

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN 9202190 Issued in FL

Practice address

17913 SW 5TH St
Pembroke Pines, FL 33029-4119

Phone

(954) 854-4765

NPI assigned

Feb 21, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1194264242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17913 SW 5TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294119",
            "telephone_number": "954-854-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17913 SW 5TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294119",
            "telephone_number": "954-854-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLOCK",
        "first_name": "AZEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9202190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramona Lynn Walker
• Donna C. Wallace, PHARMD
• Karen Wallace
• Elaine Wallen
• Sara Grace Wallin, PA-C
• Walnut Creek Medical Center, Inc
• Michael Francis Walsh II, MD
• Demetrius Walton
• Stephen H Wander, D.D.S.
• Yasheng Wang

• Registered Nurse in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.