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GENESISCARE USA OF FLORIDA LLC NPI 1255741880


NPI Information

NPI: 1255741880
Provider Name: GENESISCARE USA OF FLORIDA LLC

Doing Business As: GULF COAST UROLOGY

Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 10D2189842

Address:
21260 OLEAN BLVD
SUITE 202A
PORT CHARLOTTE, FL
ZIP 33952
Phone: (941) 625-1550
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GENESISCARE USA OF FLORIDA LLC is an urology in Port Charlotte, FL. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. GENESISCARE USA OF FLORIDA LLC NPI is 1255741880. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gulf Coast Urology.

The provider's business location address is:

21260 OLEAN BLVD
SUITE 202A
PORT CHARLOTTE, FL
ZIP 33952-742
Phone: (941) 625-1550
Fax: (941) 255-0794

The provider's authorized official is Shaden Marzouk .
The authorized official title is President and has the following contact phone number (239) 931-7254.

The CLIA number assigned to this NPI record is 10D2189842 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/5/2014 and was last updated on 10/5/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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