LYDIA V. WALLACE, D.O., P.A.
NPI 1861766941
Clinic/Center - Community Health in Hollywood, FL

Active since March 07, 2012
3021 N 66TH AVE, HOLLYWOOD, FL 33024(754) 281-8202 Get Directions Write a Review

NPPES record last updated: March 7, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lydia V. Wallace, D.o., P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LYDIA V. WALLACE, D.O., P.A. (NPI 1861766941) is a healthcare organization registered as a community health in Hollywood, Florida and active in the NPI registry since March 2012. The organization lists Lydia Valladares Wallace, Owner, as its authorized official.

NPPES Registry Identity

NPI1861766941
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameLYDIA V. WALLACE, D.O., P.A.
Location Address3021 N 66TH AVEHollywood, FL 33024-2925
Mailing Address3021 N 66th AveHollywood, FL 33024-2925 · (754) 281-8202
Organization SubpartNo
Authorized OfficialLydia Valladares WallaceOwner · (954) 721-8202
Enumeration DateMarch 7, 2012
NPI 1861766941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
License Licensed in FL · OS 10688
3021 N 66TH AVE, Hollywood, FL 33024

Other Identifiers 2

Medicaid352349931FL
Medicare OSCAR/certificationCB085AFL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lydia V. Wallace, D.O., P.A.'s NPI number?

The NPI number for Lydia V. Wallace, D.O., P.A. is 1861766941. It was assigned to this organization in the NPPES registry on March 7, 2012.

Where is Lydia V. Wallace, D.O., P.A. located?

Lydia V. Wallace, D.O., P.A. is located at 3021 N 66th Ave, Hollywood, FL 33024. The listed phone number is (754) 281-8202.

What is Lydia V. Wallace, D.O., P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

When was this NPI record last updated?

The NPPES record for Lydia V. Wallace, D.O., P.A. was last updated on March 7, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.