Healthcare Provider Details

I. General information

NPI: 1750298014
Provider Name (Legal Business Name): GENES STATEWIDE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 S N ST APT 2
LAKE WORTH FL
33460-5650
US

IV. Provider business mailing address

1217 S N ST APT 2
LAKE WORTH FL
33460-5650
US

V. Phone/Fax

Practice location:
  • Phone: 772-874-5674
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DIELEURUMANUEL SAINT FLEUR
Title or Position: OWNER
Credential:
Phone: 772-458-9637