Organization
GENESISCARE USA OF FLORIDA LLC
Active
Parent organization
GENESISCARE USA INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESISCARE USA INC.
Authorized official
IAN WONG (CFO)
(303) 249-7486
Entity
Organization
Contact information
Practice address
7341 GLADIOLUS DR, FORT MYERS, FL 33908-5122
(239) 489-3420
(239) 489-3219
Mailing address
1419 SE 8TH TER STE 200, CAPE CORAL, FL 33990-3213
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
2085R0203X
Therapeutic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
208800000X
Urology Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060239600
—
FL
05
—
060239601
—
FL
05
—
060239602
—
FL
05
—
060239604
—
FL
05
—
060239605
—
FL
05
—
060239606
—
FL
05
—
060239607
—
FL
05
—
060239608
—
FL
05
—
060239609
—
FL
05
—
060239611
—
FL
05
—
060239612
—
FL
05
—
060239615
—
FL
05
—
060239616
—
FL
05
—
060239617
—
FL
05
—
060239619
—
FL
05
—
060239621
—
FL
01
—
CE7138
RAILROAD MEDICARE
FL
01
—
CE9586
RAILROAD MEDICARE
FL
Enumeration date
01/19/2006
Last updated
11/03/2025
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