Individual
MS. GAYLE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5105 PORTER RD, ST AUGUSTINE, FL 32095-6247
(904) 825-4876
Mailing address
5105 PORTER RD, ST AUGUSTINE, FL 32095-6247
(904) 825-4876
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230641700
—
FL
Enumeration date
09/23/2009
Last updated
09/23/2009
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