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Latoya M. Wallace, PA
Physician Assistant in Pensacola, Florida
NPI 1073764114

Latoya M. Wallace is a Physician Assistant based in Pensacola, FL. Latoya M. Wallace practices in Pensacola, FL and has the professional credentials of PA. The NPI Number for Latoya M. Wallace is 1073764114 and holds a License No. 4254 (Florida).

The current practice location address for Latoya M. Wallace is 1010 N 12Th Ave Ste 125, Pensacola, FL and can be reached out via phone at 850-361-8598 and via fax at 850-203-4629. You can also correspond with Latoya M. Wallace through the mailing address at 1010 N 12TH AVE, PENSACOLA, FL - 32501-3370 (mailing address contact number: 410-908-7714).

Location: 1010 N 12Th Ave Ste 125, Pensacola, FL, 32501-3370
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073764114
Provider Name
Latoya M. Wallace
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
1010 N 12Th Ave Ste 125, Pensacola, FL, 32501-3370
Phone Number
850-361-8598
Fax Number
850-203-4629
Provider Enumeration Date
10/07/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZA98W 01 FL BCBSFL
institution
Provider Business Practice Location Address Details
Address
1010 N 12Th Ave Ste 125
City
Pensacola
State
Florida
Zip
32501-3315
Phone Number
850-361-8598
Fax Number
850-203-4629
person
Provider Business Mailing Address Details
Address
1010 N 12Th Ave Ste 125
City
Pensacola
State
Florida
Zip
32501-3315
Phone Number
850-361-8598
Fax Number
850-203-4629
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
PA9109974 (Florida)
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA9109974 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
4254 (Arizona)
Definition
Definition to come...
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