Individual
MS. ADRIANA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, LMHC
Contact information
Practice address
26601 AIRPORT RD, PUNTA GORDA, FL 33982-2408
(941) 833-6300
(941) 833-6300
Mailing address
2707 PANKAW LN, VALRICO, FL 33596-6515
(813) 598-8482
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAP 4364
FL
101YA0400X
Addiction (Substance Use Disorder) Counselor
MH10983
FL
101YM0800X
Mental Health Counselor
MH10983
FL
2084P0800X
Psychiatry Physician
Primary
NP11038978
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
FL
Enumeration date
08/18/2010
Last updated
04/28/2025
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