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General NPI Number Information
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NPI Number | 1639317290
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Entity Type | Organization
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Legal Business Name | GARDNER PLASTIC SURGERY INC
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1250 PINE RIDGE RD STE 101C
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City | NAPLES
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State | FL
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Zip | 34108-8913
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Country | US
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Telephone | 239-566-2611
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Fax | 239-431-8069
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Provider Business Mailing Address
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Address Line | 1250 PINE RIDGE RD STE 101C
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City | NAPLES
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State | FL
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Zip | 34108-8913
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Country | US
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Telephone | 239-566-2611
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Fax | 239-431-8069
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Authorized Official
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Title or Position | MANAGER
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Name | DR. PAUL MICHAEL GARDNER
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Credential | MD
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Telephone | 239-877-2239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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