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

Dr. Danielle Charisse Wallace, MD

Individual provider Pediatrics Physician · NPI 1114147006

Dr. Danielle Charisse Wallace, MD is a Pediatrics Physician in Winter Park, Florida. Works from 3 locations. Licensed in Florida, Michigan, Texas and Utah and 1 more.

Licensed in
FL, MI, TX, UT, WA
In the registry since
2007
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1801 Lee Rd Ste 165
Winter Park, FL 32789
Phone: (407) 975-0410
Fax: (407) 975-0413
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4845 Alameda Ave, El Paso, TX 79905-2705 — (915) 215-5700
  • 1627 S 3050 W, Vernal, UT 84078-8719 — (616) 717-3171

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence ME129213 (FL)
Pediatrics Physician Taxonomy 208000000X · Licence MD61340360 (WA)
Pediatrics Physician Taxonomy 208000000X · Licence 8023169-1205 (UT)
Pediatrics Physician Taxonomy 208000000X · Licence 4301088447 (MI)
Pediatrics Physician Taxonomy 208000000X · Licence U0741 (TX)

Record details

NPI number1114147006
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 26, 2007
Last updated in NPPESJune 13, 2023
Certification dateJune 1, 2023
Mailing address100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560

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