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General NPI Number Information
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NPI Number | 1750280731
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Entity Type | Organization
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Legal Business Name | GENESI ALLIANCE LLC
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 2820 NE 214TH ST STE 811
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City | AVENTURA
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State | FL
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Zip | 33180-1270
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Country | US
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Telephone | 786-354-1183
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 NE 214TH ST STE 811
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City | AVENTURA
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State | FL
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Zip | 33180-1270
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Country | US
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Telephone | 786-354-1183
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ITALO MARIO GENESI
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Credential | APRN
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Telephone | 786-354-1183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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