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General NPI Number Information
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NPI Number | 1356152177
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Entity Type | Organization
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Legal Business Name | GENESIS SURGERY CENTER OF FLORIDA, LLC
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 625 6TH AVE S STE 475
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-4637
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Country | US
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Telephone | 727-518-2977
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Fax | 727-518-0010
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Provider Business Mailing Address
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Address Line | 625 6TH AVE S STE 475
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-4637
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Country | US
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Telephone | 727-518-2977
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Fax | 727-518-0010
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MELISSA MEININGER
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Credential |
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Telephone | 727-240-1935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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