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Individual

MS. ADRIANA WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC, APRN

Contact information

Practice address
2340 COMMERCE POINT DR, LAKELAND, FL 33801-6880
(863) 709-8543
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
06/16/2026
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