Organization
ERAD IMAGING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK E GONWA MD (SOLE MEMBER)
(561) 795-9150
Entity
Organization
Contact information
Practice address
2500 HARBOR BLVD, PORT CHARLOTTE, FL 33952-5000
(941) 766-4122
Mailing address
4440 PGA BLVD, SUITE 402, PALM BEACH GARDENS, FL 33410-6539
(561) 795-9150
(561) 798-7700
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
09/29/2008
Last updated
09/29/2008
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