Individual
DR. MARY S GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14055 RIVEREDGE DR STE 250, TAMPA, FL 33637-2141
(813) 929-5451
Mailing address
14055 RIVEREDGE DR STE 250, TAMPA, FL 33637-2141
(813) 929-5451
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME59197
FL
2085R0202X
Diagnostic Radiology Physician
ME59197
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053313100
—
FL
01
—
12131
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/24/2005
Last updated
09/16/2025
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