MRS. MARY ELAINE WAGNER


Address: 1364 Westdale Ave, Winter Park, FL 32792-6059
Phone: 3214397229

MRS. MARY ELAINE WAGNER (NPI# 1720361033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720361033
Entity Type Individual
Full Name MRS. MARY ELAINE WAGNER
Other Name MISS MARY ELAINE GANT
Credential RPH
Practice Address 1364 Westdale Ave
Winter Park
FL 32792-6059
Practice Telephone 3214397229
Practice Fax Number 4076570267
Mailing Telephone 3214397229
Mailing Fax Number 4076570267
Enumeration Date 2011-09-22
Last Update Date 2011-09-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1835P0018X Pharmacist
Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PS22749 FL Pharmacy Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL PHARMACIST LICENSE NUMBER PS22749 01

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Office Location

Street Address 1364 WESTDALE AVE
City WINTER PARK
State FL
Zip Code 32792-6059

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225647589 Interim Personal Care Services, LLC Home Health 1890 State Road 436, Suite 355, Winter Park, FL 32792 2020-07-23
1710510649 Chrisline Badio Clinic/Center 3040 Aloma Ave Apt J12, Winter Park, FL 32792 2020-02-19
1679112411 The Local Health Council of East Central Florida, Inc. Voluntary or Charitable 5931 Brick Court, Suite 164, Winter Park, FL 32792 2019-12-26
1710534201 Robert Scott Hughes Occupational Therapy Assistant 925 South Semoran Blvd, #110a, Winter Park, FL 32792 2019-08-20
1164077962 Dentists of Winter Park, Pa Dentist 1973 Aloma Avenue, Winter Park, FL 32792 2019-08-08
1659938637 Adventist Health System/sunbelt Inc Dba Adventhealth Orlando Pharmacy 2005 Mizell Avenue, Suite 900, Winter Park, FL 32792 2019-05-24
1104397801 Jose M Martinez Rivera Chiropractor 471 N Semoran Blvd., Suite B, Orlando, FL 32792 2018-12-07
1750875720 Andrea Nalborczyk Student in an Organized Health Care Education/Training Program 133 Benmore Dr #200, Winter Park, FL 32792 2018-06-21
1841787157 Rd Health Diagnostic LLC Clinical Medical Laboratory 6904 Aloma Ave, Winter Park, FL 32792 2018-04-23
1548763006 Daniel Remington Geer Hearing Instrument Specialist 7007 University Blvd, Winter Park, FL 32792 2018-03-12
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Taxonomy Information

Taxonomy Code 1835P0018X
Grouping Pharmacy Service Providers
Classification Pharmacist
Specialization Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Taxonomy Definition

Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.
Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740571827 Michael W Johnson Pharmacist 306 S Park Ave, Winter Park, FL 32789-4318 2011-04-25

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1821696345 Cynthia Barbara Guerrero Gentile Pharmacist 11231 Macaw Ct, Windermere, FL 34786-5635 2020-10-16
1568069276 Shannon Lea Wright Pharmacist 2021 Camden Loop, Davenport, FL 33837-1796 2020-10-06
1013514603 Tien Thuy Hoang Pharmacist 875 Dr M.l.k. Jr St N, St. Petersburg, FL 33701 2020-10-06
1497361976 Ruxandra Ivascu Pharmacist 11782 E Dr Martin Luther King Jr Blvd, Seffner, FL 33584-4923 2020-09-20
1306458450 Usif Darwish Pharmacist 3863 Us 301 S, Riverview, FL 33578-3572 2020-08-20
1528685203 Caren Azurin Pharmacist 23965 Us 27, Lake Wales, FL 33859-7812 2020-06-29
1700400314 Tonisha Simone Robinson Seixas Pharmacist 13280 Nw 18th St, Pembroke Pines, FL 33028-2502 2020-05-31
1942820287 Sirisha Kandepi Pharmacist 8217 Miramar Way, Lakewood Ranch, FL 34202-9003 2020-04-16
1891323713 Ralph Ranie Razon Pharmacist 3135 Sr 580 Ste 15, Suite 15, Safety Harbor, FL 34695-3528 2020-03-27
1710518477 Richard D Moss Pharmacist 160 Sw 12 Avenue, Suite 101 D, Deerfield Beach, FL 33442 2020-01-31
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Competitor

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City WINTER PARK
Zip Code 32792

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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