Individual
LEONARD GARDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11OO YATES ST, ORLANDO, FL 32804
(407) 422-9822
Mailing address
1100 YATES ST, ORLANDO, FL 32804-5766
(407) 422-9822
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
55588
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55588
LICENSE NUMBER
GA
05
—
636648176A
—
GA
Enumeration date
11/10/2006
Last updated
03/11/2013
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