Organization
CUSTOM RADIOLOGY SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAIM J MARGOLIN MD (MD/OWNER)
(239) 333-2484
Entity
Organization
Contact information
Practice address
13731 METROPOLIS AVE, FORT MYERS, FL 33912
(239) 333-2484
(239) 333-2483
Mailing address
13300-56 S. CLEVELAND AVE #305, PMB#239, FORT MYERS, FL 33907
(239) 333-2484
(239) 333-2483
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME62306
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME62306
MEDICAL LICENSE
FL
Enumeration date
01/30/2008
Last updated
09/26/2011
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