Michael Anthony Wallace, DO
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Bradenton, FL
NPI 1447199864 · NPPES record last updated Mar 28, 2026
Key facts
- NPI
- 1447199864
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 2020 59TH St W
Bradenton, FL 34209-4604 - Phone
- (941) 257-2581
- NPI assigned
- Mar 28, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
2020 59TH St W
Bradenton, FL 34209-4604
Mailing address
2020 59TH St W
Bradenton, FL 34209-4604
Phone (941) 257-2581
Other providers in Bradenton, FL
- Nelsie Eneida Walker
- Shanaria Walker
- Makiesha Wallace-Watson
- Beverly Wallace
- Chloe Wallace
- Stacie L Wallace
- Walsh Family Medicine LLC
- Douglas A Walsh Jr.
- Janet Sue Walsh
- Joseph Bailey Walsh
All providers in Bradenton, FL · Student in an Organized Health Care Education/Training Program in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.