Wagoner, Michael Justin

Wagoner, Michael Justin is an individual health care provider with primary practice located at 5426 Beaumont Center Blvd Ste 350 , Tampa FL 33634-5235. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Wagoner, Michael Justin can be contacted via phone (813) 286-0033.

Contact Information

Primary practice address
5426 Beaumont Center Blvd Ste 350 Tampa FL 33634-5235
Phone: (813) 286-0033
Fax: (813) 282-1806
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X TRN8871 Florida
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X ME103487 Florida

Profile Details

NPI number 1316126337
LBN Legal business name Wagoner, Michael Justin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2007
Last updated Jun 22nd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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