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
Mailing address1410 Canal Point Rd, Longwood, FL 32750-4562

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