Gardner, Mary S
Gardner, Mary S is an sole proprietor health care provider with primary practice located at 14055 Riveredge Dr Ste 250 , Tampa FL 33637-2141. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Radiation Oncology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Gardner, Mary S can be contacted via phone (813) 929-5451.Contact Information
Primary practice address
14055 Riveredge Dr Ste 250
Tampa FL 33637-2141
Phone: (813) 929-5451
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | ME59197 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME59197 | Florida |
Profile Details
| NPI number | 1508859703 |
|---|---|
| LBN Legal business name | Gardner, Mary S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2005 |
| Last updated | Jun 10th, 2026 - about 4 months ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508859703 | NPPES |
| Florida | Other | 12131 | BLUE CROSS BLUE SHIELD |
| Florida | MEDICAID | 053313100 | BLUE CROSS BLUE SHIELD |
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