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

Mrs. Cynthia Catherine Wallace, PA

Individual provider Dermatology Physician · NPI 1730596875

Mrs. Cynthia Catherine Wallace, PA is a Physician Assistant in Vero Beach, Florida. Graduated from Nova Southeastern College of Osteo Medicine in 1998, 28 years ago. Practices with Advanced Facial Cosmetic and Laser Surgery Center, LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Florida and Maryland.

Years since qualifying
28
Trained at
Nova Southeastern College of Osteo Medicine
Licensed in
FL, MD
In the registry since
2014
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5070 Highway A1A Ste A
Vero Beach, FL 32963-1229
Phone: (954) 531-9433
Show map & directions

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

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9114207 (FL)
Dermatology Physician Taxonomy 207N00000X · Licence C0005406 (MD)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1730596875
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 21, 2014
Last updated in NPPESApril 19, 2023
Certification dateApril 18, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolNOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated 1998 (28 years in practice)
Group practice Advanced Facial Cosmetic And Laser Surgery Center, Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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