Organization
GENESIS INTERNATIONAL MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE C NEWTON M.D. (PRESIDENT/ MEDICAL DIRECTOR)
(813) 389-7682
Entity
Organization
Contact information
Practice address
323 W OAK ST, SUITE A, KISSIMMEE, FL 34741-4421
(407) 468-3075
Mailing address
7529 TALL TREE CT, PORT RICHEY, FL 34668-5849
(407) 468-3075
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME50820
FL
Other
Enumeration date
04/03/2012
Last updated
05/07/2012
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