Daniel Lewis Wagoner D.O.

NPI 1184927394 - Internal Medicine - 207R00000X

NPI Details
NPI 1184927394
Gender Male
Enumeration Date 12/09/2010
Last Updated 12/09/2010
Entity Type Individual
Active Over 5 years ago
Practice Location
6000 49TH ST N
ST PETERSBURG FL, 33709-2114, US
Phone (727) 521-4411
Fax
Business Location
8572 SWEET MAGNOLIA PL
SEMINOLE FL, 33777-4600, US
Phone
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Florida
License Number UO2539
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According to our database, Dr. Daniel Lewis Wagoner D.O. NPI is 1184927394, taxonomy code is 207R00000X and license number is UO2539, license state is located at Florida. Daniel Lewis Wagoner D.O. physically located at 6000 49th St N, St Petersburg FL, 33709-2114. NPI Number Daniel Lewis Wagoner D.O. has the Individual type.

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1184927394 NPI number is provided on an as is basis without warranty of any kind. 1184927394 is maintained by the National Plan & Provider Enumeration System. The contents of Daniel Lewis Wagoner D.O. are for informational purposes only.