Healthcare Provider Details

I. General information

NPI: 1558679449
Provider Name (Legal Business Name): ZACHARY GARNER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 BARKLEY CIR
FORT MYERS FL
33907-7593
US

IV. Provider business mailing address

PO BOX 947407
ATLANTA GA
30394-7407
US

V. Phone/Fax

Practice location:
  • Phone: 239-275-8882
  • Fax:
Mailing address:
  • Phone: 941-917-2600
  • Fax: 941-917-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS12213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: