Healthcare Provider Details

I. General information

NPI: 1497668073
Provider Name (Legal Business Name): GENESIS MEDICAL TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

6691 RAINWOOD COVE LN
LAKE WORTH FL
33463-7449
US

IV. Provider business mailing address

6691 RAINWOOD COVE LN
LAKE WORTH FL
33463-7449
US

V. Phone/Fax

Practice location:
  • Phone: 561-306-0100
  • Fax:
Mailing address:
  • Phone: 561-306-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: YOSSELET VIBERT
Title or Position: OWNER
Credential:
Phone: 561-797-6567