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Organization

GENOA HEALTHCARE OF FL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN MARTYN (PRESIDENT)
(753) 218-0862
Entity
Organization

Contact information

Practice address
1437 S BELCHER RD, CLEARWATER, FL 33764-2829
(727) 533-9073
(727) 533-9184
Mailing address
510 EASTERN ST, AUBUURN, WA 98002

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
3336C0003X
Community/Retail Pharmacy
PH22102
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1020356
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
08/10/2006
Last updated
09/11/2025
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