Individual
GAVIN CARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
151 SOUTHHALL LN STE 300, MAITLAND, FL 32751-7172
(866) 400-3376
Mailing address
151 SOUTHHALL LN STE 300, MAITLAND, FL 32751-7172
(866) 400-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS21622
FL
208D00000X
General Practice Physician
Primary
0102206466
VA
Other
Enumeration date
03/23/2019
Last updated
03/11/2026
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