Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME62716 | FL |
NPI | 1790853091 |
---|---|
Provider Name | Dr. Linda J Gardiner |
First Address | Fort Myers, FL 33919-6063 |
Second Address | Fort Myers, FL 33919-6063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 31/10/2007 |