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1679068092
KASIA LAYNE WALLACE-SHAW
PALM BAY, FL
NPI
1679068092
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Former Name
KASIA LAYNE WALLACE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: FL ME148403)
Enumeration Date
2018-06-27
Last Update Date
2024-05-17
Business Address
KASIA LAYNE WALLACE-SHAW MD
5270 BABCOCK ST NE STE 1
PALM BAY, FL 32905-4616
Phone number: 321-241-6800
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Mailing Address
KASIA LAYNE WALLACE-SHAW MD
PO BOX 1137
MELBOURNE, FL 32902-1137
Phone number: 321-952-9696
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