Organization
ID CONSULTS AND SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL WALLACE (BUSINESS MANAGER)
(770) 977-5056
Entity
Organization
Contact information
Practice address
3142 NORTHSIDE DR, SUITE 101, KEY WEST, FL 33040-8012
(305) 615-3300
Mailing address
3142 NORTHSIDE DR, SUITE 101, KEY WEST, FL 33040-8012
(305) 615-3300
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME 114239
FL
Other
Enumeration date
03/11/2013
Last updated
10/17/2013
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