Gardner, Mario

Gardner, Mario is an individual health care provider with primary practice located at 137 Crystal Beach Dr Ste 121 , Destin FL 32541-3573. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Nursing Service Providers / Registered Nurse, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Gardner, Mario can be contacted via phone (850) 807-4388.

Contact Information

Primary practice address
137 Crystal Beach Dr Ste 121 Destin FL 32541-3573
Phone: (850) 807-4388
Fax: (850) 862-0605
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN11006004 Florida
Nursing Service Providers / Registered Nurse 163W00000X RN9265919 Florida
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 2083P0011X APRN11006004 Florida

Profile Details

NPI number 1679117451
LBN Legal business name Gardner, Mario
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2019
Last updated Feb 15th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679117451 NPPES
Florida MEDICAID 105938800

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