Provider Demographics
NPI:1669554135
Name:PACE, BILLIE JEAN (MD)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:JEAN
Last Name:PACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 BALLARD ST
Mailing Address - Street 2:STE 1000
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5426
Mailing Address - Country:US
Mailing Address - Phone:407-331-7784
Mailing Address - Fax:407-339-0640
Practice Address - Street 1:707 BALLARD ST
Practice Address - Street 2:STE 1000
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5426
Practice Address - Country:US
Practice Address - Phone:407-331-7784
Practice Address - Fax:407-339-0640
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46215207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59972OtherBCBS
FLE30198Medicare UPIN
FL59972ZMedicare PIN