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1679887707
BERNICE E WALLACE
PLANTATION, FL
NPI
1679887707
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: FL ARNP1772012)
Enumeration Date
2010-07-30
Last Update Date
2012-02-16
Business Address
-- BERNICE E WALLACE
4101 NW 4TH ST SUITE 200
PLANTATION, FL 33317-2850
Phone number: 954-791-5420
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Mailing Address
-- BERNICE E WALLACE
4101 NW 4TH ST SUITE 200
PLANTATION, FL 33317-2850
Phone number: 954-791-5420
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