Wagner, Laura Katherine

Wagner, Laura Katherine is an individual health care provider with primary practice located at 1222 S Orange Ave , Orlando FL 32806-1215. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Wagner, Laura Katherine can be contacted via phone (407) 423-7777.

Contact Information

Primary practice address
1222 S Orange Ave Orlando FL 32806-1215
Phone: (407) 423-7777
Fax: (407) 423-1380
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9111160 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9111160 Florida

Profile Details

NPI number 1679076285
LBN Legal business name Wagner, Laura Katherine
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2018
Last updated Apr 23rd, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679076285 NPPES
Florida MEDICAID 024256600

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