DR. LYDIA VALLADARES WALLACE (NPI# 1215139381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215139381 |
| Entity Type | Individual |
| Full Name | DR. LYDIA VALLADARES WALLACE |
| Credential | D.O. |
| Practice Address |
131 S Citrus Ave Inverness FL 34452-4701 |
| Practice Telephone | 3523446930 |
| Practice Fax Number | 3523444955 |
| Mailing Telephone | 3523446930 |
| Mailing Fax Number | 3523444955 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2017-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS 10688 | FL | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | OS 10688 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 001933100 | 05 | |
| FL | 006676100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417344581 | Lydia Wallace | Emergency Medicine | 101 Hospital Loop Ne, Albuquerque, NM 87109-2129 | 2015-04-16 |
| Street Address |
131 S CITRUS AVE |
| City | INVERNESS |
| State | FL |
| Zip Code | 34452-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417930926 | Michael R Lamarche | Internal Medicine | 131 S Citrus Ave, Inverness, FL 34452-4701 | 2005-11-29 |
| 1427358621 | Citrus Memorial Health Foundation Inc | Family Medicine | 131 S Citrus Ave, Inverness, FL 34452-4701 | 2010-10-22 |
| 1922337732 | Wound Care Consultants Pa | Surgery | 131 S Citrus Ave, Inverness, FL 34452-4701 | 2009-12-08 |
| 1912049628 | Todd Sisto Md Pa | Specialist | 131 S Citrus Ave, Suite 307, Inverness, FL 34452-4701 | 2007-02-12 |
| 1366505786 | Karen Marie Nieradka | Physician Assistant | 131 S Citrus Ave, Inverness, FL 34452-4701 | 2006-12-18 |
| 1578595484 | Stephen Paul Johnson | Nurse Anesthetist, Certified Registered | 131 S Citrus Ave, Inverness, FL 34452-4701 | 2006-07-07 |
| 1811929730 | Nancy Connor | Nurse Anesthetist, Certified Registered | 131 S Citrus Ave, Suite 2, Pod 4, Inverness, FL 34452-4701 | 2006-07-07 |
| 1689603417 | Jacque A Goulet | Nurse Anesthetist, Certified Registered | 131 S Citrus Ave, Suite 2, Pod 4, Inverness, FL 34452-4701 | 2006-07-02 |
| 1801839683 | Citrus Cardiovascular Associates Pl | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 131 S Citrus Ave, Suite 305, Inverness, FL 34452-4701 | 2006-06-13 |
| 1013966530 | P Kenneth Newman Md Pa | Anesthesiology | 131 S Citrus Ave, Inverness, FL 34452-4701 | 2006-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680204 | Medical Risk Solutions LLC | Family Medicine | 216-c South Apopka Ave., Inverness, FL 34452 | 2020-05-15 |
| 1801354204 | Mari Parker | Nurse Practitioner | 520 W Highland Blvd, Inverness, FL 34452 | 2019-03-05 |
| 1346737061 | Sharma Institute of Pain Medicine | Physical Medicine & Rehabilitation | 211 South Seminole Ave, Inverness, FL 34452 | 2018-04-18 |
| 1548779846 | Alexandra Weinmann | Behavior Technician | 6765 E Kingsbury Lane, Inverness, FL 34452 | 2017-09-29 |
| 1821536913 | Mechelle Louise Lewis | Nurse Practitioner | 212 S. Pine Avenue, Inverness, FL 34452 | 2017-02-08 |
| 1639615131 | Elizabeth Lynch | Behavioral Analyst | 609 Goodyear Ave, Inverness, FL 34452 | 2017-01-09 |
| 1942511100 | Families Come First, LLC | In Home Supportive Care | 220 S Pine Ave, Invenress, FL 34452 | 2010-06-23 |
| 1639342470 | Assisted Living Concepts Inc | Assisted Living Facility | 700 Medical Court East, Inverness, FL 34452 | 2008-04-11 |
| 1063684686 | Winn-dixie Stores, Inc. | Durable Medical Equipment & Medical Supplies | 333 Highland Ave Space 600, Inverness, FL 34452 | 2008-03-25 |
| 1831372606 | Gira S. Shah, Md, Pa | Internal Medicine | 203 S. Seminole Ave, Inverness, FL 34452 | 2007-12-14 |
| Find all providers in zip 34452 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680204 | Medical Risk Solutions LLC | Family Medicine | 216-c South Apopka Ave., Inverness, FL 34452 | 2020-05-15 |
| 1679828552 | Joshua A Summers Md Pa | Family Medicine | 3878 E Country Side Dr, Inverness, FL 34452-8834 | 2012-07-17 |
| 1366624827 | Philip Richard Wirt IIi | Family Medicine | 9494 Wateroak Ct, Inverness, FL 34453-1707 | 2007-11-27 |
| 1154529618 | Kesava Krishna Bhogaraju | Family Medicine | 900 Middleton Ln, Inverness, IL 60010-6136 | 2007-07-06 |
| 1871713651 | Faramarz H Ghazi-tehrani | Family Medicine | 151 E Highland Blvd, Inverness, FL 34452-4846 | 2007-04-26 |
| 1831251446 | Hasibul Hassan Khan | Family Medicine | 213 S Pine Ave, Inverness, FL 34452-4830 | 2006-12-14 |
| 1144309485 | Pablo E Figueroa | Family Medicine | 2222 Highway 44 W, Inverness, FL 34453 | 2006-11-06 |
| 1609897719 | Habtu Megenta Adera | Family Medicine | 227 Ella Ave, Inverness, FL 34450-3911 | 2006-07-22 |
| 1588609093 | Robert B Holstein | Family Medicine | 101 S Osceola Ave, Inverness, FL 34452-4727 | 2006-06-18 |
| 1548221104 | Stephan A Bart Sr Md Pa | Family Medicine | 204 S Apopka Ave, Inverness, FL 34452-4803 | 2006-03-31 |
| Find all providers in INVERNESS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.