GLENN DAVID GARDNER (NPI# 1861483810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861483810 |
| Entity Type | Individual |
| Full Name | GLENN DAVID GARDNER |
| Credential | MD |
| Practice Address |
1324 Valentine St Melbourne FL 32901-3128 |
| Mailing Address |
200 E Sheridan Rd Melbourne FL 32901-3142 |
| Practice Telephone | 3217253200 |
| Practice Fax Number | 3217254175 |
| Mailing Telephone | 3217253200 |
| Mailing Fax Number | 3217254175 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2008-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
ME42838 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE | 102907209 | 01 |
| FL | 038995100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881647675 | Glenn Gardner | Anesthesiology | 3815 Highland Ave, Downers Grove, IL 60515-1500 | 2006-05-19 |
| 1982653929 | Glenn C Gardner | Surgery | 7710 Mercy Road, Suite 305, Omaha, NE 68124 | 2006-05-08 |
| 1932165321 | Glenn Pierce Gardner | Surgery | 1086 Franklin St, Ste 3002, Johnstown, PA 15905-4305 | 2006-04-25 |
| Street Address |
1324 VALENTINE ST |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568447753 | Jose W. Ruiz | Otolaryngology | 1324 Valentine St, Melbourne, FL 32901-3128 | 2005-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700983863 | Shireen F Gadallah | Internal Medicine | 25 Silver Palm Ave, Suite B, Melbourne, FL 32901-3177 | 2006-09-20 |
| 1467556456 | Peter A Koretsky | Internal Medicine | 2955 Pineda Plaza Way Ste 115, Melbourne, FL 32940-7306 | 2006-09-11 |
| 1275519548 | Scott Seminer | Internal Medicine | 1334 Valentine St, Melbourne, FL 32901-3128 | 2005-12-19 |
| 1164406500 | Jeremiah Paul Donovan | Internal Medicine | 6235 Anello Dr, Melbourne, FL 32940 | 2005-11-30 |
| 1922081983 | Athan P Kartsonis | Internal Medicine | 1301 Hickory St, Melbourne, FL 32901-3223 | 2005-11-23 |
| 1316937535 | Kaseng Derek Chan-pong | Internal Medicine | 1223 Gateway Dr Ste B, Melbourne, FL 32901-2607 | 2005-10-27 |
| 1114917655 | Charles A Farrington | Internal Medicine | 1223 Gateway Dr Ste 2b, Melbourne, FL 32901-2607 | 2005-10-26 |
| 1700870847 | Mark Douglas Hughes | Internal Medicine | 8725 N Wickham Rd Ste 200, Melbourne, FL 32940-2240 | 2005-09-06 |
| 1033101985 | Martin E Avalos | Internal Medicine | 8725 N Wickham Rd, Suite 302, Melbourne, FL 32940-5997 | 2005-08-17 |
| 1235591025 | Mark C. Dillon, M.d. Pllc | Internal Medicine | 3150 N Wickham Rd, Suite 6, Melbourne, FL 32935-2322 | 2016-03-22 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.