Custom Radiology Solutions LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME62306 Issued in FL

Legal business name

CUSTOM RADIOLOGY SOLUTIONS LLC

Practice address

13731 Metropolis Ave
Fort Myers, FL 33912

Phone

(239) 333-2484

Fax

(239) 333-2483

NPI assigned

Jan 30, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chaim J Margolin, MDNPI 1700825551

Title

MD/Owner

Phone

(239) 333-2484

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chaim J Margolin, MD

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1700825551
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1073790291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300-56 S. CLEVELAND AVE #305",
            "address_2": "PMB#239",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "239-333-2484",
            "fax_number": "239-333-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13731 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-333-2484",
            "fax_number": "239-333-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM RADIOLOGY SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "MARGOLIN",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "239-333-2484",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME62306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME62306",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.