Wagner, Gisela L

Wagner, Gisela L is an sole proprietor health care provider with primary practice located at 1223 Gateway Dr Suite 1E, Melbourne FL 32901-2607. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Wagner, Gisela L can be contacted via phone (321) 312-3312.

Contact Information

Primary practice address
1223 Gateway Dr Suite 1E Melbourne FL 32901-2607
Phone: (321) 312-3312
Fax: (321) 984-8483
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X ME98773 Florida

Profile Details

NPI number 1316916448
LBN Legal business name Wagner, Gisela L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2006
Last updated May 20th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316916448 NPPES
Florida Other 94667 BCBS
Florida MEDICAID 278670200 BCBS
Florida Other P01164130 BCBS

Popular Providers