| Tonialatoya Wallace-eley, MD | |
|
6201 N Suncoast Blvd, Crystal River, FL 34428-6712 | |
| (352) 795-6560 | |
| (770) 776-5966 |
| Full Name | Tonialatoya Wallace-eley |
|---|---|
| Gender | Female |
| Speciality | Pathology |
| Experience | 23 Years |
| Location | 6201 N Suncoast Blvd, Crystal River, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093988933 | NPI | - | NPPES |
| ME101987 | Other | FL | FL MEDICAL LICENSES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 4301089191 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Carolina East Medical Center | New bern, NC | Hospital |
| Carteret General Hospital | Morehead city, NC | Hospital |
| Duke University Hospital | Durham, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Atlantic Pathology Group Pa | 0547277246 | 9 |
| Entity Name | Atlantic Pathology Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356301725 PECOS PAC ID: 0547277246 Enrollment ID: O20060321000134 |
| Entity Name | App-ecp, Llc |
|---|---|
| Entity Type | Part B Supplier - Independent Clinical Laboratory |
| Entity Identifiers | NPI Number: 1578708368 PECOS PAC ID: 6608933221 Enrollment ID: O20090326000402 |
| Entity Name | Carolinaeast Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104066794 PECOS PAC ID: 0143378117 Enrollment ID: O20090430000303 |
| Mailing Address | Practice Location Address |
|---|---|
| Tonialatoya Wallace-eley, MD Po Box 2030, Homosassa Springs, FL 34447-2030 Ph: (352) 621-3100 | Tonialatoya Wallace-eley, MD 6201 N Suncoast Blvd, Crystal River, FL 34428-6712 Ph: (352) 795-6560 |
Fernando A Esclopis, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 6201 N Suncoast Blvd, Crystal River, FL 34428 Phone: 352-795-8372 | |
Dr. Jon P. Frankel, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 6201 N Suncoast Blvd, Crystal River, FL 34428 Phone: 352-795-8379 Fax: 352-795-8401 | |
Marcelino L Alvarez, MD Pathology Medicare: Medicare Enrolled Practice Location: 6201 N Suncoast Blvd, Department Of Pathology, Crystal River, FL 34428 Phone: 352-795-8372 | |
Mark Mcmullen, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 6201 N Suncoast Blvd, Crystal River, FL 34428 Phone: 352-621-3100 Fax: 352-621-3121 | |
Joana A Faber, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 6201 N Suncoast Blvd, Seven Rivers Med Center - Pathology Dept, Crystal River, FL 34428 Phone: 352-795-8372 |