Individual
SETH D GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1321
(863) 284-1730
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MANAGED CARE DEPT, LAKELAND, FL 33805-1686
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9109363
FL
Other
Enumeration date
01/23/2012
Last updated
08/04/2017
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