Individual
MS. JOYCE LYNN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1553 US HIGHWAY 1, VERO BEACH, FL 32960
(772) 257-8224
(772) 213-3157
Mailing address
1555 INDIAN RIVER BLVD STE B210, VERO BEACH, FL 32960-7113
(772) 257-8224
(722) 523-2457
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9102320
FL
363AM0700X
Medical Physician Assistant
Primary
PA9102320
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9102320
STATE LICENSE
FL
Enumeration date
04/18/2006
Last updated
02/13/2025
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