Dr. Elaine Wallace
Sports Medicine Doctor
3200 S University Dr #4316
Davie
, Florida 33328-2018
Dr. Elaine Wallace
Sports Medicine Doctor
3200 S University Dr #4316
Davie
, Florida 33328-2018
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Dr. Elaine Wallace
- 3001 W Rolling Hills Cir 1-408
- Davie, FL
- Zip : 33328-1948
- Phone :
Second Address
- Dr. Elaine Wallace
- 3200 S University Dr #4316
- Davie, FL
- Zip : 33328-2018
- Phone : (954) 262-4316
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | OS8356 | FL |
National Provider Identifier
| NPI | 1770537649 |
|---|---|
| Provider Name | Dr. Elaine Wallace |
| First Address | Davie, FL 33328-1948 |
| Second Address | Davie, FL 33328-2018 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/05/2006 |
| Last Update Date | 25/09/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E22818 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.