Individual
MR. MICHAEL WILLIAM GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3250 WINKLER AVE, FORT MYERS, FL 33916-9414
(239) 939-4993
Mailing address
7322 S BLUE SAGE, PUNTA GORDA, FL 33955-1106
(516) 680-5764
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA18035
FL
Other
Enumeration date
04/21/2021
Last updated
04/25/2021
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