MEDICARE: GENESISCARE USA OF FLORIDA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1437581089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESISCARE USA OF FLORIDA LLC

Provider Business Mailing Address
First Line	:	1419 SE 8TH TER STE 200
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3213
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	2101 RIVERSIDE DR STE 101
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6260
Country	:	US
Telephone Number	:	561-420-8770
Fax Number	:	561-420-8771

Authorized Official
Title or Position	:	CFO
Name	:	IAN WONG
Credential	:
Telephone Number	:	303-249-7486

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	11/03/2025

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Directions to “GENESISCARE USA OF FLORIDA LLC ” Practice Location

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