Cleveland Wallace

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Practice address

2513 Camden Park Cir
Davenport, FL 33837-1801

Phone

(863) 312-2612

NPI assigned

Aug 25, 2026

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

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1447167440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 CAMDEN PARK CIR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338371801",
            "telephone_number": "863-312-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 CAMDEN PARK CIR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338371801",
            "telephone_number": "863-312-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CLEVELAND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wolf Karl Von Waagner, MD
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• Kaysey Wann, MA, EDM, NCSP, LSP
• Christian Sean Watkins
• Heather Watson, PHARM.D.
• Leah Dare Weaver, PA
• Kaydian Suzzette Wedderburn

• Developmentally Disabled Services Day Training Agency in Davenport, FL
• Providers in Davenport, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.