Audrey A. Wagner MD
Family Medicine Physician in Fort Myers, FL(View on Map)
Full Name
Audrey Anne Wagner MD
NPI Number
1619556388
NPI Type
Individual Provider
Gender
Female
Enumeration Date
04/07/2021
Specialties
(Taxonomies)Code
207Q00000X
390200000X
Primary Taxonomy
Yes
No
Licenses
State
Florida
License Number
ME158286
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 2147
8960 COLONIAL CENTER DR STE 300
City
Fort Myers
Fort Myers
State
FL
FL
Postal Code
33902-2147
33905-7810
Country
US
US
Telephone Number
(239) 343-3831
(239) 343-9470
Identifiers
Identifier
115971600
Identifier State
FL
Identifier Issuer
Unknown
Health Information Exchange
Endpoint Type
DIRECT
Endpoint
awagner301401@Direct.leememorial.org
Endpoint Description
Unknown
Use
Direct
Content Type
Unknown
Affiliation
Y
Endpoint Location
Lee Memorial Health System2776 Cleveland AveFort Myers, FL339015864US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/06/2024
Provider Address
Other Family Medicine Physicians in Fort Myers, Florida:
John-paul Bettencourt DO, MPH, MBA, AAHIVS
Fort Myers, FLSpecialty: Family Medicine Physician (Primary)