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Organization

GENESIS COMMUNITY HEALTH INC

Active
Other names
Boca Raton Medical
Organization subpart
No

Provider details

NPI number
Authorized official
DEANNA M WARREN (EXECUTIVE DIRECTOR/CEO)
(561) 735-6553
Entity
Organization

Contact information

Practice address
600 S DIXIE HWY STE 103, BOCA RATON, FL 33432-6034
(561) 430-3629
(561) 990-7435
Mailing address
639 E OCEAN AVE STE 409, BOYNTON BEACH, FL 33435-5017
(561) 806-6835
(561) 806-6607

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006608606
FL
01
EC290A
MEDICARE
FL
Enumeration date
09/22/2015
Last updated
11/04/2024
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