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1255334488

NPI Code Detail

MEDICARE: DR. RONALD D GARDNER MD

MEDICARE: DR. RONALD D GARDNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME0056224	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	200039786	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	10225	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1255334488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD D GARDNER MD

Provider Business Mailing Address
First Line	:	3033 WINKLER AVE UNIT 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-9523
Country	:	US
Telephone Number	:	239-277-7070
Fax Number	:	239-277-7071

Provider Business Practice Location Address
First Line	:	3033 WINKLER AVE UNIT 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33916-9523
Country	:	US
Telephone Number	:	239-277-7070
Fax Number	:	239-277-7071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/29/2018

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Directions to “ DR. RONALD D GARDNER MD” Practice Location

Language	Start Address	Practice Location

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