Individual
JAMES MICHAEL GARDNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 UNIVERSITY BLVD STE 208, JUPITER, FL 33458-2775
(561) 627-3130
(561) 627-8971
Mailing address
500 UNIVERSITY BLVD STE 208, JUPITER, FL 33458-2775
(561) 627-3130
(561) 627-8971
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02004702A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
OS15445
FL
208M00000X
Hospitalist Physician
02004702A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201349680
—
IN
Enumeration date
03/21/2012
Last updated
07/26/2018
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