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

Ebonie Wallace

Individual provider Case Manager/Care Coordinator · NPI 1871044255

Ebonie Wallace is a Case Manager/Care Coordinator in Daytona Beach, Florida. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

140 S Beach St Ste 310
Daytona Beach, FL 32114-4409
Phone: (386) 898-6040
Fax: (386) 256-2320
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X

Record details

NPI number1871044255
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 20, 2016
Last updated in NPPESFebruary 18, 2021
Certification dateFebruary 18, 2021
Mailing address140 S Beach St, Daytona Beach, FL 32114-4472

Other providers in Daytona Beach