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Contact Information

MARK GONWA, MD
1500 N DIXIE HWAY
STE 306
WEST PALM BEACH, FL33401
 Phone: 561-837-4834
 Fax: 561-837-2225
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for MARK GONWA · (Male)

NPI Number 1275601437
Status Active
Credentials MD
Entity Individual
Enumeration date 12/04/2006
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME64311
  • FL Medicaid 378003100
  • KY Medicaid 7100037330
  • KY Other 000000545011 ANTHEM BCBS
Hospital affiliation(s)
  • INDIAN RIVER MEDICAL CENTER - (Acute Care)
    1000 36TH ST
    VERO BEACH, FL 32960
  • MARTIN MEMORIAL MEDICAL CENTER - (Acute Care)
    200 SE HOSPITAL AVE
    STUART, FL 34995
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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