IndividualActive
Lori Wagner, D.O.
NPI 1164601936 · Family Medicine Physician · Tampa, FL
Provider details
- NPI number
- 1164601936
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- License
- OS6338 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1502 E Fowler Ave
Tampa, FL 33612-5416
Phone: (813) 866-0950
Fax: (813) 866-0929
Street-level locationGet directions
Mailing address
3905 Appletree Dr
Valrico, FL 33594-4316
Registry dates
- Enumerated
- 2007-10-30
- Last updated
- 2010-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.