DANIELLE CHARISSE WALLACE

WINTER PARK, FL
NPI1114147006
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: FL  ME129213)
Additional Taxonomies208000000X Pediatrics
(Licence: WA  MD61340360)
208000000X Pediatrics
(Licence: UT  8023169-1205)
208000000X Pediatrics
(Licence: MI  4301088447)
208000000X Pediatrics
(Licence: TX  U0741)
Enumeration Date2007-04-26
Last Update Date2023-06-13
Business Address
Dr. DANIELLE CHARISSE WALLACE M.D.
1801 LEE RD STE 165
WINTER PARK, FL 32789
Phone number: 407-975-0410
Mailing Address
Dr. DANIELLE CHARISSE WALLACE M.D.
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: