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General NPI Number Information
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NPI Number | 1013875459
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Entity Type | Organization
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Legal Business Name | GENOGENRX LLC
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 1200 S ROGERS CIR STE 11
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City | BOCA RATON
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State | FL
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Zip | 33487-5703
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Country | US
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Telephone | 561-760-1060
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Fax | 561-760-1061
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Provider Business Mailing Address
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Address Line | 1200 S ROGERS CIR STE 11
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City | BOCA RATON
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State | FL
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Zip | 33487-5703
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Country | US
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Telephone | 561-760-1060
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Fax | 561-760-1061
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Authorized Official
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Title or Position | CEO
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Name | SAMUEL MIRON
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Credential |
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Telephone | 561-760-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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