Provider Demographics
NPI:1114386190
Name:PALLAIS, WALEUSKA (RN)
Entity Type:Individual
Prefix:
First Name:WALEUSKA
Middle Name:
Last Name:PALLAIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 ALTON RD
Mailing Address - Street 2:2B
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3881
Mailing Address - Country:US
Mailing Address - Phone:786-970-6811
Mailing Address - Fax:
Practice Address - Street 1:1250 ALTON RD
Practice Address - Street 2:2B
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-3881
Practice Address - Country:US
Practice Address - Phone:786-970-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9358142163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse