Individual
WAYNE M GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3844 BRANTLEY PLACE CIR, APOPKA, FL 32703-6854
(407) 733-5464
Mailing address
3844 BRANTLEY PLACE CIR, APOPKA, FL 32703-6854
(407) 733-5464
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA3289
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290329600
—
FL
Enumeration date
07/11/2005
Last updated
09/08/2008
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