Provider Demographics
NPI:1992320881
Name:ACCESS TO CARE, P.A.
Entity type:Organization
Organization Name:ACCESS TO CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:410-908-7714
Mailing Address - Street 1:4603 NORTHMOOR CT
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2456
Mailing Address - Country:US
Mailing Address - Phone:410-908-7714
Mailing Address - Fax:833-963-0920
Practice Address - Street 1:1010 N 12TH AVE STE 125
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3315
Practice Address - Country:US
Practice Address - Phone:850-361-8598
Practice Address - Fax:833-963-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty