# GENESIS MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457331308
- **Authorized official:** DR. FRANCISCO MARTINEZ-CANABATE MD (PRESIDENT)
- **Authorized official phone:** (787) 285-2415

## Contact information

- **Practice address:** 14 CALLE MIGUEL CASILLAS, HUMACAO, PR 00791-3638
- **Practice address phone:** (787) 285-2415
- **Practice address fax:** (787) 285-4590
- **Mailing address:** PO BOX 890, MCS 549, HUMACAO, PR 00792-0890
- **Mailing address phone:** (787) 285-2415
- **Mailing address fax:** (787) 285-4590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |
| 305R00000X | Preferred Provider Organization | — | NULL | — |
| 305S00000X | Point of Service | — | NULL | — |

## Other

- **Enumeration date:** 01/18/2006
- **Last updated:** 10/11/2007