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Individual

ROBERT MATISON CARGILE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 LONGWOOD AVE, ROCKLEDGE, FL 32955-2828
(321) 636-2211
Mailing address
PO BOX 919346, ORLANDO, FL 32891-9346
(727) 896-3134
(770) 666-9331

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2004010700
MO
2085R0202X
Diagnostic Radiology Physician
23847
WV
2085R0202X
Diagnostic Radiology Physician
Primary
ME111795
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14JV4
BCBS
FL
Enumeration date
01/28/2007
Last updated
04/25/2012
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