LATIERE WALLACE

DADE CITY, FL
NPI1518673854
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: FL  11023599)
Enumeration Date2023-01-30
Last Update Date2023-05-11
Business Address
LATIERE WALLACE APRN
14527 7TH ST
DADE CITY, FL 33523-3102
Phone number: 352-521-1474
Mailing Address
LATIERE WALLACE APRN
5222 BLUE ROAN WAY
WESLEY CHAPEL, FL 33544-1829
Phone number: 727-510-5070
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