Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bruce Wagner, PHYSICIANASSISTANT

Individual provider Surgical Physician Assistant · NPI 1215351697

Bruce Wagner, PHYSICIANASSISTANT is a Surgical Physician Assistant in Longwood, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2014

Practice location Address checks out

1410 Canal Point Rd
Longwood, FL 32750-4562
Phone: (407) 832-2955
Fax: (407) 339-2955
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9107368 (FL)

Record details

NPI number1215351697
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedFebruary 6, 2014
Last updated in NPPESFebruary 6, 2014

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