Fleming Island Plastic Surgery LLC
NPI 1245602069 · Plastic and Reconstructive Surgery Physician · Fleming Island, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Fleming Island Plastic Surgery LLC is a Plastic and Reconstructive Surgery Physician organization in Fleming Island, FL (NPI 1245602069).
Provider details
- NPI number
- 1245602069
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- William Wallace, Manager/Owner(904) 990-3477
- License
- ME107749 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
Mailing address
Registry dates
- Enumerated
- 2015-10-21
- Last updated
- 2024-09-13
- Certified
- 2024-09-13
Frequently asked questions
- What is Fleming Island Plastic Surgery LLC's NPI number?
- Fleming Island Plastic Surgery LLC's National Provider Identifier (NPI) is 1245602069, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fleming Island Plastic Surgery LLC?
- Fleming Island Plastic Surgery LLC is classified in the NPPES registry as Plastic and Reconstructive Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Fleming Island Plastic Surgery LLC located?
- Fleming Island Plastic Surgery LLC's practice location on file with NPPES is 1715 Eagle Harbor Pkwy Ste B, Fleming Island, FL 32003-4324.
- What is Fleming Island Plastic Surgery LLC's phone number?
- The practice phone number listed in the NPPES registry for Fleming Island Plastic Surgery LLC is (904) 990-3477.
- Does Fleming Island Plastic Surgery LLC accept Medicare?
- Fleming Island Plastic Surgery LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Fleming Island Plastic Surgery LLC?
- The authorized official listed on Fleming Island Plastic Surgery LLC's NPPES record is William Wallace, Manager/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fleming Island Plastic Surgery LLC's NPI active?
- Yes — Fleming Island Plastic Surgery LLC's NPI (1245602069) is active in the NPPES registry as of the last update on 2024-09-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.