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Individual

REBECCA A WAGAMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
330 E HIBISCUS BLVD, MELBOURNE, FL 32901-3155
(321) 724-2229
(321) 728-6668
Mailing address
330 E HIBISCUS BLVD, MELBOURNE, FL 32901-3155
(321) 724-2229
(321) 728-6668

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME49648
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046612300
FL
Enumeration date
09/07/2005
Last updated
03/05/2015
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