Gavin Cardwell

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS21622 Issued in FL

Practice address

151 Southhall LN Ste 300
Maitland, FL 32751-7172

Phone

(866) 400-3376

NPI assigned

Mar 23, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1326508581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "866-400-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "866-400-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38400 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921340001",
            "country_code": "US",
            "telephone_number": "559-906-5831",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7119 Langley St",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "FL",
            "postal_code": "325706105",
            "country_code": "US",
            "telephone_number": "850-611-0052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDWELL",
        "first_name": "GAVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-23",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS21622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Maitland, FL
• Providers in Maitland, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.