LAURA KATHERINE WAGNER PA NPI 1679076285

NPI Information

NPI: 1679076285
Provider Name: LAURA KATHERINE WAGNER, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
1222 S ORANGE AVE
ORLANDO, FL
ZIP 32806
Phone: (407) 423-7777
Get Directions

Laura Katherine Wagner, PA is a surgical physician assistant in Orlando, FL with 7 years of experience. Laura Katherine Wagner, PA NPI is 1679076285. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1222 S ORANGE AVE
ORLANDO, FL
ZIP 32806-215
Phone: (407) 423-7777
Fax: (407) 423-1380

The NPI 1679076285 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/10/2018 and was last updated on 4/23/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		9111160	FLORIDA	No
2	363AS0400X	Physician Assistant	Surgical	PA9111160	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	024256600	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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