IndividualActive
Max Wallack
NPI 1043839814 · Diagnostic Radiology Physician · Jacksonville, FL
Provider details
- NPI number
- 1043839814
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- ME176656 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
655 W 8th St
Jacksonville, FL 32209-6511
Phone: (774) 270-0554
Street-level locationGet directions
Mailing address
3580 Pall Mall Dr Apt 2604
Jacksonville, FL 32257-5486
Registry dates
- Enumerated
- 2020-04-13
- Last updated
- 2025-10-30
- Certified
- 2025-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.