# BIOGENESIS MEDICAL INC

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

## Provider details

- **NPI number:** 1568974293
- **Authorized official:** OHARA MCKENNA (PRESIDENT)
- **Authorized official phone:** (813) 253-5969

## Contact information

- **Practice address:** 2111 W SWANN AVE STE 104, TAMPA, FL 33606-2478
- **Practice address phone:** (813) 253-5969
- **Mailing address:** 2111 W SWANN AVE STE 104, TAMPA, FL 33606-2478
- **Mailing address phone:** (813) 253-5969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2017
- **Last updated:** 11/03/2017