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ROBERT VERNON WALLACE M. D.
NPI 1922113174
Family Medicine in Lehigh Acres, FL

Active since August 20, 2006
400 LEE BLVD, LEHIGH ACRES, FL 33936(239) 369-2903(239) 369-0500 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Robert Vernon Wallace M. D. NPPES

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

ROBERT VERNON WALLACE M. D. (NPI 1922113174) is an individual family medicine provider in Lehigh Acres, Florida, licensed in Florida (ME0013849) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1922113174
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameROBERT VERNON WALLACECredential: M. D.
Location Address400 LEE BLVDLehigh Acres, FL 33936-4923
Mailing AddressPo Box 848Lehigh Acres, FL 33970-0848 · (239) 369-2903 · Fax (239) 369-0500
Phone(239) 369-2903
Fax(239) 369-0500
Sole ProprietorYes
Enumeration DateAugust 20, 2006
Last NPPES UpdateMarch 7, 2023
✔ NPI 1922113174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME0013849
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
400 LEE BLVD, Lehigh Acres, FL 33936
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Other Identifiers 3

Other36161FL · Blue Cross Blue Shield
Other622647FL · Aetna
OtherME0013849FL · Professional License

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLY GRAHAM LMT
Massage Therapist
400 LEE BLVD
LEHIGH ACRES, FL 33936
Lee County (239) 369-9986

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 Robert Wallace's NPI number?

The NPI number for Robert Wallace is 1922113174. It was assigned to this individual provider in the NPPES registry on August 20, 2006.

Where is Robert Wallace located?

Robert Wallace practices at 400 Lee Blvd, Lehigh Acres, FL 33936. The listed phone number is (239) 369-2903.

What is Robert Wallace's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Robert Wallace was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.