Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lydia V Wallace, DO, PA

Organization Community Health Clinic/Center · NPI 1861766941

Lydia V Wallace, DO, PA is a Community Health Clinic/Center in Hollywood, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3021 N 66th Ave
Hollywood, FL 33024-2925
Phone: (754) 281-8202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Clinic/Center (primary) Taxonomy 261QC1500X · Licence OS 10688 (FL)

Record details

NPI number1861766941
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lydia Wallace — Owner · (954) 721-8202
NPI enumeratedMarch 7, 2012
Last updated in NPPESMarch 7, 2012
Mailing address3021 N 66th Ave, Hollywood, FL 33024-2925

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