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BRUCE WAGNER PHYSICIAN ASSISTANT
NPI 1215351697
Physician Assistant - Surgical in Longwood, FL

Active since February 06, 2014
1410 CANAL POINT RD, LONGWOOD, FL 32750(407) 832-2955(407) 339-2955 Get Directions Write a Review

NPPES record last updated: February 6, 2014. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Bruce Wagner Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRUCE WAGNER PHYSICIAN ASSISTANT (NPI 1215351697) is an individual surgical provider in Longwood, Florida, licensed in Florida (PA9107368) and active in the NPI registry since February 2014.

NPPES Registry Identity

NPI1215351697
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameBRUCE WAGNERCredential: PHYSICIAN ASSISTANT
Location Address1410 CANAL POINT RDLongwood, FL 32750-4562
Mailing Address1410 Canal Point RdLongwood, FL 32750-4562 · (407) 832-2955 · Fax (407) 339-2955
Phone(407) 832-2955
Fax(407) 339-2955
Sole ProprietorYes
Enumeration DateFebruary 6, 2014
✔ NPI 1215351697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in FL · PA9107368
1410 CANAL POINT RD, Longwood, FL 32750
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Wagner's NPI number?

The NPI number for Bruce Wagner is 1215351697. It was assigned to this individual provider in the NPPES registry on February 6, 2014.

Where is Bruce Wagner located?

Bruce Wagner practices at 1410 Canal Point Rd, Longwood, FL 32750. The listed phone number is (407) 832-2955.

What is Bruce Wagner's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Bruce Wagner was last updated on February 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.