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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

WAGNER JEAN MARY PA
NPI 1811809023
Physician Assistant in Orlando, FL

Active since September 22, 2026
48 N KIRKMAN RD STE 6, ORLANDO, FL 32811(954) 673-9512 Get Directions Write a Review

NPPES record added: September 22, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Wagner Jean Mary Pa NPPES

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

WAGNER JEAN MARY PA (NPI 1811809023) is an individual physician assistant in Orlando, Florida, licensed in Puerto Rico (001187-P.A.) and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1811809023
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameWAGNER JEAN MARYCredential: PA
Location Address48 N KIRKMAN RD STE 6Orlando, FL 32811-1466
Mailing Address17545 Bella Nova DrOrlando, FL 32820-1446 · (954) 673-9512
Phone(954) 673-9512
Sole ProprietorYes
Enumeration DateSeptember 22, 2026
NPPES CertifiedSeptember 21, 2026
✔ NPI 1811809023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in PR · 001187-P.A.
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
48 N KIRKMAN RD STE 6, Orlando, FL 32811
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Wagner Jean Mary's NPI number?

The NPI number for Wagner Jean Mary is 1811809023. It was assigned to this individual provider in the NPPES registry on September 22, 2026.

Where is Wagner Jean Mary located?

Wagner Jean Mary practices at 48 N Kirkman Rd Ste 6, Orlando, FL 32811. The listed phone number is (954) 673-9512.

What is Wagner Jean Mary's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Wagner Jean Mary was last updated on September 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.