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

Individual provider Family Nurse Practitioner · NPI 1982243630

Mr. Itamar Wall, APRN is a Nurse Practitioner in Loxahatchee, Florida. Qualified in 2019, 7 years ago. Practices with Fairway Physical Therapy LLC, a 82-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

13005 Southern Blvd Ste 221
Loxahatchee, FL 33470-9272
Phone: (561) 517-8678
Fax: (561) 529-5087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN11005498 (FL)

Record details

NPI number1982243630
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorNo
NPI enumeratedDecember 29, 2019
Last updated in NPPESJuly 21, 2026
Certification dateJuly 21, 2026
Mailing address13005 Southern Blvd Ste 221, Loxahatchee, FL 33470-9272

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Fairway Physical Therapy Llc — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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