Provider Demographics
NPI:1386185932
Name:GINTER, MYRNA B (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRNA
Middle Name:B
Last Name:GINTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 ORTEGA BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-4415
Mailing Address - Country:US
Mailing Address - Phone:904-699-8459
Mailing Address - Fax:
Practice Address - Street 1:3805 ORTEGA BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-4415
Practice Address - Country:US
Practice Address - Phone:904-699-8459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME10053208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics