Mark E Gonwa MD PLLC Team Radiology

Organization Active NPI Diagnostic Radiology Physician · Port Charlotte, FL

NPI 1497925895 · NPPES record last updated Aug 20, 2008

Key facts

NPI
1497925895
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
ME64311 (FL)
Legal business name
MARK E GONWA MD PLLC TEAM RADIOLOGY
Practice address
2500 Harbor Blvd
Port Charlotte, FL 33952-5000
Phone
(941) 766-4382
NPI assigned
Mar 3, 2008
Organization subpart
No

Authorized official

Name
Mark E Gonwa, MD
Title
President
Phone
(516) 625-8584

Practitioners 1

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

National Provider Directory

Locations

4440 Pga Blvd
Ste 402
Palm Beach Gardens, FL 33410

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2085R0202X ME64311 FL Yes

Addresses

Primary practice location

2500 Harbor Blvd
Port Charlotte, FL 33952-5000

Mailing address

4440 Pga Blvd
Suite 402
Palm Beach Gardens, FL 33410-6539
Phone (516) 625-8584

Other providers in Port Charlotte, FL

All providers in Port Charlotte, FL · Diagnostic Radiology Physician in Florida

Sources for this page

Verify at the official NPI Registry.