Dana V Wallace, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

ME0025502 Issued in FL

Practice address

2699 Stirling Rd Ste B305
Ft Lauderdale, FL 33312-6546

Phone

(954) 981-9180

Fax

(954) 961-4752

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437192531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 SW 40TH ST",
            "address_2": "SUITE 304",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753584",
            "telephone_number": "305-223-8808",
            "fax_number": "305-223-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 STIRLING RD STE B305",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126546",
            "telephone_number": "954-981-9180",
            "fax_number": "954-961-4752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N 35th Ave",
            "address_2": "Suite 460",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215424",
            "country_code": "US",
            "telephone_number": "954-981-9180",
            "fax_number": "954-961-4752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DANA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME0025502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006256200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "93292X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savannah Walker
• Scott F Walker
• Tiffannie Walker, M.D.
• George L Wallace-Barnhill, PHD LMHC
• Jill Amy Wallace-Ross, DO
• Gabrielle Wallace, CRNA
• Grace Christianne Manuela Wallace, WHNP
• Jenece Wallace
• Karina M Wallace, BCBA,
• Tanya Wallen

• Allergy & Immunology Physician in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Allergy & Immunology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.