NPIMap

Organization Active NPI

Wallace Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Hollywood, FL
National Provider Identifier
1407335268
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
WALLACE PHYSICAL THERAPY LLC
Practice address
1830 Radius Dr Apt 910
Hollywood, FL 33020-7716
Phone
(786) 476-2706
NPI assigned
Aug 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Authorized official

Name
Jocelyn WallaceNPI 1154845600
Title
Owner/Physical Therapist
Phone
(813) 407-9004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1830 Radius Dr Apt 910
Hollywood, FL 33020-7716

Mailing address

1830 Radius Dr Apt 910
Hollywood, FL 33020-7716

Other names 1

  • ResolveRx Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1407335268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 RADIUS DR APT 910",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330207716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 RADIUS DR APT 910",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330207716",
            "telephone_number": "786-476-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-12",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "813-407-9004"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ResolveRx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.