Organization
MARK E GONWA MD PLLC TEAM RADIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E GONWA MD (PRESIDENT)
(516) 625-8584
Entity
Organization
Contact information
Practice address
2500 HARBOR BLVD, PORT CHARLOTTE, FL 33952-5000
(941) 766-4382
Mailing address
4440 PGA BLVD, SUITE 402, PALM BEACH GARDENS, FL 33410-6539
(516) 625-8584
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME64311
FL
Other
Enumeration date
03/03/2008
Last updated
08/20/2008
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