Organization
TRIAD RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MILES E GILMAN (PRESIDENT)
(305) 665-1197
Entity
Organization
Contact information
Practice address
1500 LEE BLVD, LEHIGH ACRES, FL 33936-4835
(239) 368-4710
(941) 637-3873
Mailing address
329 E OLYMPIA AVE, PUNTA GORDA, FL 33950-3833
(941) 637-9729
(941) 637-3873
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98264
BCBSFL
FL
Enumeration date
08/28/2007
Last updated
03/06/2008
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