| Entity Name: | DAN GARDNER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Jun 1987 (38 years ago) |
| Document Number: | J80678 |
| FEI/EIN Number | 592808333 |
| Address: | 6615 Gunn Hwy, Tampa, FL, 33625, US |
| Mail Address: | 6615 Gunn Hwy, Tampa, FL, 33625, US |
| ZIP code: | 33625 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063515955 | 2006-09-06 | 2011-02-04 | 700 SE 5TH TERR, SUITE 12, CRYSTAL RIVER, FL, 344294877, US | 700 SE 5TH TERR, SUITE 12, CRYSTAL RIVER, FL, 344294877, US | |||||||||||||||||||||
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| Phone | +1 352-795-5377 |
| Fax | 3527958663 |
Authorized person
| Name | MR. DANIEL P GARDNER |
| Role | PRESIDENT |
| Phone | 3527955377 |
Taxonomy
| Taxonomy Code | 231H00000X - Audiologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS & BLUE SHIELD |
| Number | J0279 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DANIEL GARDNER | Agent | 2928 11th Ave N, St Petersburg, FL, 33713504 |
| Name | Role | Address |
|---|---|---|
| GARDNER DANIEL P | Chief Executive Officer | 2928 11th Ave N, St Petersburg, FL, 33713504 |
| Name | Role | Address |
|---|---|---|
| Conter Joanne Dr. | Chief Operating Officer | 700 SE 5TH TERR, CRYSTAL RIVER, FL, 34429 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000096532 | HEARGATE | EXPIRED | 2018-08-29 | 2023-12-31 | No data | 700 SE 5TH TER, STE 11, CRYSTAL RIVER, FL, 34429 |
| G06227900174 | GARDNER AUDIOLOGY | ACTIVE | 2006-08-15 | 2026-12-31 | No data | 6615 GUNN HWY, TAMPA, FL, 33625 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
