Active NPI
Lawrence W Gardner Jr MD PA
- Gastroenterology Physician
- Cape Coral, FL
National Provider Identifier
1194026849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME0034362
- Legal business name
- LAWRENCE W GARDNER JR MD PA
- Practice address
- 708 Del Prado Blvd
Suite 5
Cape Coral, FL 33990-5616 - Phone
- (239) 574-8616
- Fax
- (239) 574-4451
- NPI assigned
- Nov 11, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Lawrence Gardner, M.D., F.A.C.G.
- Title
- President
- Phone
- (239) 574-8616
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME0034362 | FL | Primary |
Addresses
Primary practice location
708 Del Prado Blvd
Suite 5
Cape Coral, FL 33990-5616
Mailing address
708 Del Prado Blvd
Suite 5
Cape Coral, FL 33990-5616
Phone (239) 574-8616
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038581-600 | Medicaid | FL | |
| 1972653632 | Other | FL | NPI |
| 79466 | Other | FL | PTIN |
National Provider Directory
National Provider DirectoryLocations
708 Del Prado Blvd S
Ste 5
Cape Coral, FL 33990
Phone (239) 574-8616
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Dietitian
- New York, NY
- NPI 1306081401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289433600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1305158400000",
"number": "1194026849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 DEL PRADO BLVD",
"address_2": "SUITE 5",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339905616",
"telephone_number": "239-574-8616",
"fax_number": "239-574-4451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 DEL PRADO BLVD",
"address_2": "SUITE 5",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339905616",
"telephone_number": "239-574-8616",
"fax_number": "239-574-4451"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAWRENCE W GARDNER JR MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2010-11-11",
"last_updated": "2011-05-12",
"status": "A",
"authorized_official_last_name": "GARDNER",
"authorized_official_first_name": "LAWRENCE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "239-574-8616",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D., F.A.C.G."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME0034362",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038581-600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1972653632",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTIN",
"identifier": "79466",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.