Organization
GENESIS PHYSICIANS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN A HENGOED (OFFICE MANAGER)
(813) 876-4900
Entity
Organization
Contact information
Practice address
4600 N HABANA AVE, #27, TAMPA, FL 33614-7112
(813) 876-4900
(813) 876-4997
Mailing address
4600 N HABANA AVE, #27, TAMPA, FL 33614-7112
(813) 876-4900
(813) 876-4997
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/20/2011
Last updated
05/02/2011
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