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Contact Information

JOHN D WALLACE
1455 NW 53RD ST APT 222
MIAMI, FL33142
 Phone: 904-418-3893
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Homemaker

376J00000X
 

Adult Companion

372600000X
 

Mental Health

101YM0800X
 

Respite Care

385H00000X
Indicates primary specialty

NPI Profile & details for JOHN D WALLACE · (Male)

NPI # 1679900161
Status Active
Credentials
Entity Individual
Enumeration date 09/30/2013
Last updated 06/29/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # 235276
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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