# GENESISCARE OF FLORIDA LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GENESISCARE USA INC
- **Other names:** Head & Neck Surgical Cancer Specialists of SW Florida
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1528442332
- **Legal business name:** GENESISCARE USA INC
- **Authorized official:** IAN WONG (CFO)
- **Authorized official phone:** (303) 249-7486

## Contact information

- **Practice address:** 4571 COLONIAL BLVD STE 110, FORT MYERS, FL 33966-1156
- **Practice address phone:** (239) 790-3480
- **Practice address fax:** (239) 244-2049
- **Mailing address:** 1419 SE 8TH TER STE 200, CAPE CORAL, FL 33990-3213
- **Mailing address phone:** (239) 931-7342
- **Mailing address fax:** (239) 931-7385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/13/2015
- **Last updated:** 11/03/2025