MEDICARE: GENESIS SCIENCES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1841072972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS SCIENCES, INC.

Provider Business Mailing Address
First Line	:	4011 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5528
Country	:	US
Telephone Number	:	954-564-4222
Fax Number	:	954-564-4326

Provider Business Practice Location Address
First Line	:	4011 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5528
Country	:	US
Telephone Number	:	954-564-4222
Fax Number	:	954-564-4326

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	RYAN LAMARCA
Credential	:	MD
Telephone Number	:	954-564-4222

Provider Enumeration Date	:	10/13/2023
Last Update Date	:	10/13/2023

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Directions to “GENESIS SCIENCES, INC. ” Practice Location

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