MEDICARE: EVELINE S. WALLACE ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	1728202	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00360116	OTHER	FL	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1427058932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELINE S. WALLACE ARNP

Provider Business Mailing Address
First Line	:	2415 N ORANGE AVE
Second Line	:	SUITE # 700
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-7171
Fax Number	:	407-303-7195

Provider Business Practice Location Address
First Line	:	2415 N ORANGE AVE
Second Line	:	SUITE # 700
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-303-7171
Fax Number	:	407-303-7195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	11/11/2021

Similar Medicare Providers

1942288808 — MANUEL RAMON PEREZ-IZQUIERDO MD
Practice Location Address:

2415 N ORANGE AVE STE 302
ORLANDO, FL
32804-5505

Practice Phone: 407-303-7250
Practice Fax: 407-303-7255

1962401331 — NIRAV Y. RAVAL MD
Practice Location Address:

2415 N ORANGE AVE , SUITE 600
ORLANDO, FL
32804-5505

Practice Phone: 407-303-2172
Practice Fax: 407-303-0678

1770577504 — DR. MICHAEL ANGELIS MD
Practice Location Address:

2415 N ORANGE AVE , SUITE 700
ORLANDO, FL
32804-5505

Practice Phone: 407-303-2474
Practice Fax: 407-303-0680

1376524553 — DR. JOHN D BUSOWSKI MD
Practice Location Address:

2415 N ORANGE AVE STE 402
ORLANDO, FL
32804-5505

Practice Phone: 407-622-0560
Practice Fax:

1275504987 — DEBORAH ANN WAHLER NP
Practice Location Address:

2415 N ORANGE AVE , SUITE 700
ORLANDO, FL
32804-5505

Practice Phone: 407-303-2474
Practice Fax:

1811948128 — DONALD MURRILL BOTTA M.D.
Practice Location Address:

2415 N ORANGE AVE , SUITE 700
ORLANDO, FL
32804-5505

Practice Phone: 407-303-2474
Practice Fax: 407-303-0680

Directions to “ EVELINE S. WALLACE ARNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.