Organization · NPI-2

Erad Imaging Services PLLC

Radiology, Diagnostic Radiology · Port Charlotte, FL

NPI number1114177961

StatusActive

Last updated in NPPESSep 29, 2008

Details

NPI: 1114177961
Entity type: Organization (NPI-2)
Legal business name: Erad Imaging Services PLLC
Organization subpart: No
Enumeration date: Sep 29, 2008
Last updated: Sep 29, 2008

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2085R0202X	Radiology, Diagnostic Radiology	–	–	Yes

Practice location

2500 Harbor Blvd
Port Charlotte, FL 33952-5000

Phone 941-766-4122

Mailing address

4440 Pga Blvd
Suite 402
Palm Beach Gardens, FL 33410-6539

Phone 561-795-9150 · Fax 561-798-7700

Authorized official

Mark E Gonwa
Sole Member
5617959150

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