Danielle Charisse Wallace, M.D.
Pediatrics Physician · Winter Park, FL
Practice location
1801 Lee Rd Ste 165Winter Park, FL 32789
- Phone
- (407) 975-0410
- Fax
- (407) 975-0413
NPI record
- NPI
- 1114147006
- Entity type
- Individual (Type 1)
- Enumeration date
- April 26, 2007
- Last updated
- June 13, 2023
- Certified
- June 1, 2023
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Physician Primary | 208000000X |
ME129213 | FL |
| Pediatrics Physician | 208000000X |
MD61340360 | WA |
| Pediatrics Physician | 208000000X |
8023169-1205 | UT |
| Pediatrics Physician | 208000000X |
4301088447 | MI |
| Pediatrics Physician | 208000000X |
U0741 | TX |
Mailing address
100 Michigan St NE # MC845Grand Rapids, MI 49503-2560
Other practice locations (2)
- 1627 S 3050 W, Vernal, UT 84078-8719 · (616) 717-3171
- 4845 Alameda Ave, El Paso, TX 79905-2705 · (915) 215-5700
About Dr. Wallace
Danielle Charisse Wallace, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 1801 Lee Rd Ste 165, Winter Park, FL 32789. The NPI number 1114147006 was assigned on April 26, 2007 and the record was last updated on June 13, 2023.
Dr. Wallace lists 5 licenses in the registry: #ME129213 (FL) for Pediatrics Physician; #MD61340360 (WA) for Pediatrics Physician; #8023169-1205 (UT) for Pediatrics Physician; #4301088447 (MI) for Pediatrics Physician; #U0741 (TX) for Pediatrics Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Danielle Charisse Wallace, M.D.?
The NPI number is 1114147006.
What is the phone number of Dr. Wallace?
The phone number listed for the practice location is (407) 975-0410.
Where is Dr. Wallace located?
1801 Lee Rd Ste 165, Winter Park, FL 32789.
What is the taxonomy code for Dr. Wallace?
The primary taxonomy code is 208000000X – Pediatrics Physician; 4 more listed above.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
Other Pediatrics Physician providers in Winter Park
- Nicholo J. Sartor, MD1801 Lee Rd Ste 165
- Vanessa Alisa Gutierrez, M.D.200 N Lakemont Ave
- Lakemont Pediatrics157 N Lakemont Ave
- Clifford Allen Selsky2830 Casa Aloma Way
- MD Saif Al Haque, MD2325 W Fairbanks Ave
- Kidswoods Pediatrics Corp1936 Lee Rd
- Family First Pediatrics P a2830 Casa Aloma Way
- Axys Health Group1245 W Fairbanks Ave
- Fatan Jaafar, MD340 N Wymore Rd Ste B
- Zully E. Ambroise, MD1936 Lee Rd
- Watch Me Grow Pediatrics, LLC3586 Aloma Ave
- Winter Park Pediatrics Center, PLLC1245 W Fairbanks Ave Ste 500