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Active NPI 1053063834 Individual Practitioner Female Practitioner

Ima Latoya Wallace

Technician, Other • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Ima Wallace is a registered healthcare professional specializing in Technician, Other in Jacksonville, FL. Practice services are available at 9951 ATLANTIC BLVD STE 300 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9951 Atlantic Blvd Ste 300

Jacksonville, FL 322256574

Telephone 8334345223
Fax 8886866271
Associated Practice Facility / Clinic
🏢 Jace Laboratories And Screening Llc Facility NPI 1225703648

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician, Other in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 29.5 Yrs
Regional Practice Density
34 Specialists

Practicing in Jacksonville, FL (1307 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-06-17
Technician, Other Primary Specialty

NUCC Taxonomy Code: 247200000X

A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location June 17, 2022

Registered at 9951 ATLANTIC BLVD STE 300, JACKSONVILLE, FL 322256574 (Tel: 8334345223)

📍
Updated Business Mailing Address June 17, 2022

Registered at 9951 ATLANTIC BLVD STE 300, JACKSONVILLE, FL 322256574 (Tel: 8334345223)

✅
NPI Profile Active January 22, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location January 22, 2022

Registered at 9951 ATLANTIC BLVD STE 434, JACKSONVILLE, FL 322256553 (Tel: 8334345223)

📍
Updated Business Mailing Address January 22, 2022

Registered at 1168 W 9TH ST, JACKSONVILLE, FL 322095641 (Tel: 9174544703)

👤
Provider Name / Credentials Updated January 22, 2022

Recorded as IMA WALLACE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 22, 2022

Technician, Other

🟢
Initial NPI Registration & Enumeration January 22, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053063834
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 22, 2022
Last Update: June 17, 2022
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

9951 Atlantic Blvd Ste 300

Jacksonville, FL 322256574

Phone: 8334345223

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.