Tasha Wallace, DO

FAMILY PRACTICE

14651 Palm Beach Blvd

Suite 100

Fort Myers, FL 339052331

(239) 369-2903

**NPI:** 1396736997

**Med School:** ROWAN UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE

**Experience:** 25 years

**Telehealth:** No

**Medicare Assignment:** Yes

Practice Locations (2)

14651 Palm Beach Blvd, Suite 100
Fort Myers, FL 339052331

Phone: (239) 369-2903

**Group ID:** | **Group Size:** members

LEGACY HEALTHCARE SERVICES INC

1499 S Brandywine Cir
Fort Myers, FL 339196775

Phone: (239) 202-0059

**Group ID:** 2163339722 | **Group Size:** 3474 members

LEE MEMORIAL HOSPITAL Type: Hospital
2776 CLEVELAND AVE
Phone: (239) 343-5000
Medicare CCN: 100012 View Profile

CAPE CORAL HOSPITAL Type: Hospital
636 DEL PRADO BLVD
Phone: (239) 424-2000
Medicare CCN: 100244 View Profile

Home health agency Type: Home health agency
Medicare CCN: 109786 View Profile

MIPS performance data is not available or not publicly reported.

Procedure volume data is not available for public display.

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