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Individual

DR. JOHANA BEATRIZ CASTRO WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
11200 SEMINOLE BLVD STE 310, LARGO, FL 33778-3239
(727) 397-8557
(727) 397-4459
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038

Taxonomy

Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
ME124372
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020623000
FL
01
DQI18
BCBS
FL
Enumeration date
05/09/2012
Last updated
01/12/2026
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