DANIEL LEWIS WAGONER

ST PETERSBURG, FL
NPI1184927394
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: FL  uo2539)
Enumeration Date2010-12-09
Last Update Date2010-12-09
Business Address
Dr. DANIEL LEWIS WAGONER D.O.
6000 49TH ST N
ST PETERSBURG, FL 33709-2114
Phone number: 727-521-4411
Mailing Address
Dr. DANIEL LEWIS WAGONER D.O.
8572 SWEET MAGNOLIA PL
SEMINOLE, FL 33777-4600
Phone number: