Search › Florida › 152W00000X
Jason Wallace, OD
NPI 1689751166 · on the registry since 2006
Practice
- Address
- 502 Celebration Ave
Celebration, FL 34747 - Phone
- (407) 566-8505
- Fax
- (407) 566-8253
- Organisation at this address
- Christine Y Blick Od Pa
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-11-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida