Healthcare Provider Details
I. General information
NPI: 1689055782
Provider Name (Legal Business Name): GENESIS CRITICAL CARE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2015
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5352 LINTON BOULEVARD
DELRAY BEACH FL
33484
US
IV. Provider business mailing address
PO BOX 160672
ALTAMONTE SPRINGS FL
32716-0672
US
V. Phone/Fax
- Phone: 412-822-7410
- Fax: 412-822-7411
- Phone: 412-822-7410
- Fax: 412-822-7411
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARK
ADELMAN
Title or Position: OWNER/PARTNER
Credential: MD
Phone: 412-822-7410