LYDIA V. WALLACE, D.O., P.A.
Ambulatory Health at 66 Ave, Hollywood, FL

License number
Florida OS 10688
Category
Ambulatory Health
Type
Community Health
Owner
Name: DR. LYDIA VALLADARES WALLACE D.O.
Title: OWNER
Phone: (954) 721-8202
Address
Address
3021 N 66Th Ave, Hollywood, FL 33024
National Provider ID: 1861766941
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about LYDIA V. WALLACE, D.O., P.A. at bizstanding.com

Lydia Valladares Wallace DO PA

Hollywood, FL  -  Pompano Beach, FL

Status:
Inactive
Industry:
Business Services at Non-Commercial Site
Doing business as:
Lydia V. Wallace DO PA
Registration:
Jul 2, 2009
Addresses:
3021 NW 66 Ave, Hollywood, FL 33024
5491 N University Dr, Pompano Beach, FL 33067
State ID:
P09000057078
Business type:
Domestic for Profit Corporation
President, Director:
Lydia Wallace President, Director, inactive

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