Organization
GENESISCARE USA OF FLORIDA LLC
Active
Parent organization
GENESISCARE USA INC
Other names
Comprehensive Breast Center
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
9960 CENTRAL PARK BLVD N STE 100, BOCA RATON, FL 33428-1702
(954) 345-2718
(954) 753-2683
Mailing address
2270 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE7138
RAILROAD MEDICARE
FL
Enumeration date
08/24/2007
Last updated
06/22/2023
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