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General NPI Number Information
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NPI Number | 1780319558
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Entity Type | Individual
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Provider Name | ANA LUZ GARDNER
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Gender | Female
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 6240 MIRAMAR PKWY
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City | MIRAMAR
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State | FL
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Zip | 33023-3942
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Country | US
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Telephone | 954-391-9972
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Fax |
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Provider Business Mailing Address
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Address Line | 9606 NW 26TH PL
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City | SUNRISE
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State | FL
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Zip | 33322-2741
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Country | US
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Telephone | 754-779-1454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW17816
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License Number State | FL
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