Organization
GULF COAST RADIOLOGY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAIM JAY MARGOLIN MD (OWNER)
(239) 333-2484
Entity
Organization
Contact information
Practice address
13731 METROPOLIS AVE, FORT MYERS, FL 33912-7150
(239) 333-2484
Mailing address
13731 METROPOLIS AVE, FORT MYERS, FL 33912-7150
(239) 333-2484
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
03/15/2013
Last updated
03/26/2013
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