Adriana L Wagner

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

11320 Scribner Station LN
Lithia, FL 33547

Phone

(813) 707-4774

Fax

(813) 949-7535

NPI assigned

Aug 22, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1346497203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11320 SCRIBNER STATION LN",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "33547",
            "telephone_number": "813-707-4774",
            "fax_number": "813-949-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11320 SCRIBNER STATION LN",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "33547",
            "telephone_number": "813-707-4774",
            "fax_number": "813-949-7535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ADRIANA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222Q00000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vy Truong, DDS
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• Cynthia Valenzuela Lopez
• Varnika Reddy Vummalreddy
• Sandra Kay Wagner, COTA
• Walgreen Co
• Tyler Thomas Walkinshaw
• Kelsey Waltz, PA-C
• Amanda Lee Ward, FNP-C

• Developmental Therapist in Lithia, FL
• Providers in Lithia, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.