Provider Demographics
NPI:1962560888
Name:GARDNER, LINDA MARIE AMANDA (ARNP, NP-C)
Entity type:Individual
Prefix:MRS
First Name:LINDA MARIE
Middle Name:AMANDA
Last Name:GARDNER
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:MS
Other - First Name:LINDA MARIE
Other - Middle Name:AMANDA
Other - Last Name:BLOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP, NP-C
Mailing Address - Street 1:4509 W ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5631
Mailing Address - Country:US
Mailing Address - Phone:954-609-0753
Mailing Address - Fax:
Practice Address - Street 1:10920 MCKINLEY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-6471
Practice Address - Country:US
Practice Address - Phone:813-745-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9174274363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health