Individual
CASSANDRA ANN WALLACE-WICAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2350 SUNSET POINT RD STE C, CLEARWATER, FL 33765-1443
(727) 797-3155
(727) 797-4301
Mailing address
2350 SUNSET POINT RD STE C, CLEARWATER, FL 33765-1443
(727) 797-3155
(727) 797-4301
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP9204048
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
03/14/2010
Last updated
02/06/2023
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