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Individual

ALONA WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
900 PINE ST UNIT 216-217, ENGLEWOOD, FL 34223-4418
(941) 474-5093
Mailing address
1078 EISENHOWER DR, NOKOMIS, FL 34275-4411
(813) 451-5701

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11018027
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
11018027
FL

Other

Enumeration date
02/14/2022
Last updated
02/21/2022
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