Provider Type Icon

GENESISCARE USA OF FLORIDA LLC NPI 1427339399


NPI Information

NPI: 1427339399
Provider Name: GENESISCARE USA OF FLORIDA LLC

Doing Business As: BASIL D FOSSUM MD

Classification: Urology - 208800000X
Entity Type: Organization
Address:
914 MAR WALT DR
SUITE B
FORT WALTON BEACH, FL
ZIP 32547
Phone: (850) 226-6572
Get Directions

GENESISCARE USA OF FLORIDA LLC is an urology in Fort Walton Beach, 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 1427339399. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Basil D Fossum Md.

The provider's business location address is:

914 MAR WALT DR
SUITE B
FORT WALTON BEACH, FL
ZIP 32547-706
Phone: (850) 226-6572
Fax: (850) 862-8564

The provider's authorized official is Dan Collins .
The authorized official title is President and has the following contact phone number (239) 931-7275.

The enumeration date for this NPI number is 9/6/2011 and was last updated on 8/24/2020.


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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.