Individual
MARIANNE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.C.N.P.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-6531
Mailing address
11111 SW 236TH TER, HOMESTEAD, FL 33032-6232
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
9180454
FL
363LA2200X
Adult Health Nurse Practitioner
APRN9180454
FL
Other
Enumeration date
05/05/2009
Last updated
06/19/2024
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