Organization
GENESIS COMMUNITY HEALTH, INC.
Active
Other names
Boynton Beach Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA MOULTRIE WARREN (CEO)
(561) 735-6553
Entity
Organization
Contact information
Practice address
709 S FEDERAL HWY STE 3, BOYNTON BEACH, FL 33435-5610
(561) 735-6553
(561) 735-7739
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
208D00000X
General Practice Physician
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002267000
—
FL
05
—
006608600
—
FL
01
—
101108
MEDICARE
FL
01
—
EC290A
MEDICARE
FL
Enumeration date
05/05/2010
Last updated
11/04/2024
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