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General NPI Number Information
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NPI Number | 1598118176
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Entity Type | Organization
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Legal Business Name | GULF COAST MRI LLC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 116 S PINELLAS AVE
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-3632
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Country | US
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Telephone | 727-934-0513
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Fax | 727-934-0514
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Provider Business Mailing Address
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Address Line | 116 S PINELLAS AVE
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-3632
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Country | US
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Telephone | 727-934-0513
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Fax | 727-934-0514
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER J. GLEIS
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Credential | M.D.
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Telephone | 631-521-1961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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