Organization
GENESISCARE USA OF FLORIDA LLC
Active
Parent organization
GENESISCARE USA INC.
Other names
Matthew R Bagan DO
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
18308 MURDOCK CIR, SUITE 105, PORT CHARLOTTE, FL 33948-1025
(941) 743-4150
(941) 743-4427
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
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
10/02/2013
Last updated
09/28/2023
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