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1326309501
SHAWN MICHAEL WALLACE
VALRICO, FL
NPI
1326309501
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL ME122253)
Enumeration Date
2012-06-04
Last Update Date
2021-06-08
Business Address
SHAWN MICHAEL WALLACE M.D.
2211 LITHIA CENTER LN
VALRICO, FL 33596-5676
Phone number: 813-660-7100
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Mailing Address
SHAWN MICHAEL WALLACE M.D.
2211 LITHIA CENTER LN
VALRICO, FL 33596-5676
Phone number: 813-660-7100
Copy
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