# DANA V WALLACE MD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114960879
- **Authorized official:** DR. DANA V WALLACE MD (PRESIDENT)
- **Authorized official phone:** (954) 963-5363

## Contact information

- **Practice address:** 2699 STIRLING ROAD, SUITE B305, FT LAUDERDALE, FL 33312
- **Practice address phone:** (954) 963-5363
- **Practice address fax:** (954) 963-7099
- **Mailing address:** 2699 STIRLING ROAD, SUITE B305, FT LAUDERDALE, FL 33312
- **Mailing address phone:** (954) 963-5363
- **Mailing address fax:** (954) 963-7099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | Yes |
| 207K00000X | Allergy & Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 08/22/2020