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1215351697
BRUCE WAGNER
LONGWOOD, FL
NPI
1215351697
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: FL pa9107368)
Enumeration Date
2014-02-06
Last Update Date
2014-02-06
Business Address
-- BRUCE WAGNER physician assistant
1410 CANAL POINT RD
LONGWOOD, FL 32750-4562
Phone number: 407-832-2955
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Mailing Address
-- BRUCE WAGNER physician assistant
1410 CANAL POINT RD
LONGWOOD, FL 32750-4562
Phone number: 407-832-2955
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