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

Mr. Bryan J Wagner, OT, ATC, LAT

Individual provider Athletic Trainer · NPI 1871016295

Mr. Bryan J Wagner, OT, ATC, LAT is an Athletic Trainer in Jacksonville, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2017
Specialties on file
2
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1045 Riverside Ave, Jacksonville, FL 32201 — (904) 647-4284

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT24282 (FL)
Athletic Trainer Taxonomy 2255A2300X · Licence AL4839 (FL)

Record details

NPI number1871016295
Entity typeIndividual (Type 1)
GenderMale
Credentials OT , ATC , LAT
Sole proprietorNo
NPI enumeratedJuly 18, 2017
Last updated in NPPESOctober 21, 2024
Certification dateOctober 21, 2024

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