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GENESISCARE OF FLORIDA LLC NPI 1528442332


NPI Information

NPI: 1528442332
Provider Name: GENESISCARE OF FLORIDA LLC

Doing Business As: HEAD & NECK SURGICAL CANCER SPECIALISTS OF SW FLORIDA

Classification: Otolaryngology - 207YX0007X
Entity Type: Organization

Specialization: Plastic Surgery within the Head & Neck

CLIA Number: 10D0673910

Address:
4571 COLONIAL BLVD
SUITE 210
FORT MYERS, FL
ZIP 33966
Phone: (239) 333-0772
Get Directions

GENESISCARE OF FLORIDA LLC is a plastic surgery within the head and neck otolaryngology in Fort Myers, FL. The provider is an otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. GENESISCARE OF FLORIDA LLC NPI is 1528442332. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Head & Neck Surgical Cancer Specialists Of Sw Florida.

The provider's business location address is:

4571 COLONIAL BLVD
SUITE 210
FORT MYERS, FL
ZIP 33966-156
Phone: (239) 333-0772

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 CLIA number assigned to this NPI record is 10D0673910 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2015 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
1207YX0007XOtolaryngologyPlastic Surgery within the Head & NeckYes

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

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