Organization
GENESISCARE USA OF FLORIDA LLC
Active
Parent organization
GENESISCARE USA INC.
Other names
Vanguard Urology
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESISCARE USA INC.
Authorized official
SHADEN MARZOUK (PRESIDENT)
(239) 931-7254
Entity
Organization
Contact information
Practice address
600 N HIATUS RD STE 209, PEMBROKE PINES, FL 33026-5207
(954) 965-9860
(954) 965-9870
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
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
02/13/2012
Last updated
10/05/2023
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