MARK GENCO (NPI# 1285980110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285980110 |
| Entity Type | Individual |
| Full Name | MARK GENCO |
| Credential | DO |
| Practice Address |
13813 Metro Pkwy Fort Myers FL 33912 |
| Mailing Address |
3434 Hancock Bridge Pkwy Ste 301 North Fort Myers FL 33903-7099 |
| Practice Telephone | 2399631343 |
| Practice Fax Number | 2399638507 |
| Mailing Telephone | 8778563774 |
| Mailing Fax Number | 2395992612 |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2018-08-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS13988 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508228131 | Mark Genco | Dentist | 418 Saint Marks Pl, Staten Island, NY 10301-2434 | 2016-03-23 |
| Street Address |
13813 METRO PKWY |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194723569 | Daniel Louis Axelrod | Internal Medicine | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2005-07-11 |
| 1265076988 | Cortlon Hartz | Physical Therapist | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2019-11-06 |
| 1891260360 | Cathy Jean Larino | Physical Therapist | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2018-10-10 |
| 1982110847 | Olena V Bauer | Nurse Practitioner | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2017-12-14 |
| 1548712821 | Barbara Jean Kropacek | Dietitian, Registered | 13813 Metro Pkwy, Suite 203, Fort Myers, FL 33912-4343 | 2016-11-02 |
| 1467812768 | Talonda Williams | Nurse Practitioner | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2016-02-29 |
| 1750764346 | Cassady Lozzi | Physical Therapist | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2015-07-01 |
| 1821498098 | Marva Deane Lynch-phelps | Nurse Practitioner | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2014-08-25 |
| 1912310509 | Kimberly Hogan | Nurse Practitioner | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2014-06-11 |
| 1780004564 | Coram Alternate Site Services, Inc. | Clinic/Center | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2014-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134684814 | Performance Health Surgery Center | Clinic/Center | 9500 Gulf Research Lane, Fort Myers, FL 33912 | 2019-02-06 |
| 1609351899 | Voa Lee County Health Care Facility, Inc. | Skilled Nursing Facility | 14750 Hope Center Loop, Ft. Myers, FL 33912 | 2018-10-03 |
| 1245719954 | Lauren Grimes | Pharmacist | 13711 S Tamiami Trail, Fort Myers, FL 33912 | 2018-08-13 |
| 1972080828 | Solaris Rehab, LLC | Clinic/Center | 14001 Metro Parkway, Fort Myers, FL 33912 | 2018-07-24 |
| 1467943803 | Marie Veronica Scott | Nurse Practitioner | 14015 Danpak Loop, Fort Myers, FL 33912 | 2018-05-22 |
| 1952892291 | Daniels Modern Dentistry, Pa | Dentist | 6871 Daniels Parkway, Suite 100, Fort Myers, FL 33912 | 2018-05-22 |
| 1295258994 | Julie Ann Jakobi | Counselor | 18 Quanery Court, Fort Myers, FL 33912 | 2017-07-25 |
| 1205359908 | Maria Reyes | Developmental Therapist | 8961 Daniels Center Drive Suite 401, Fort Myers, FL 33912 | 2017-07-25 |
| 1669919288 | Darinka Ruiz | Social Worker | 961 Daniels Center Drive, Suite 401, Fort Myers, FL 33912 | 2017-01-20 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| Find all providers in zip 33912 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404809 | Rhc Ft Myers LLC | Family Medicine | 7051 Cypress Ter Ste 106, Fort Myers, FL 33907-8801 | 2020-10-13 |
| 1295373660 | Caloosa Medical Center, LLC | Family Medicine | 14651 Palm Beach Blvd Ste 100, Fort Myers, FL 33905-2331 | 2019-12-17 |
| 1669945119 | Cleveland Rehabilitation Center, LLC | Family Medicine | 35 Barkley Cir Ste 1&2, Fort Myers, FL 33907-7601 | 2019-01-08 |
| 1003388083 | Annie Taylor Millis | Family Medicine | 15420 Cemetery Rd, Fort Myers, FL 33905-7532 | 2019-01-01 |
| 1194189852 | Hailon Wong | Family Medicine | 2780 Cleveland Ave Ste 8709, Fort Myers, FL 33901-5858 | 2016-04-08 |
| 1588087076 | Larry Philip Garrett | Family Medicine | 3543 Stuart Ct, Fort Myers, FL 33901 | 2014-02-04 |
| 1801154794 | Ashley M Warmoth | Family Medicine | 12545 New Brittany Blvd Ste 26, Fort Myers, FL 33907-3625 | 2012-04-27 |
| 1699055376 | Health Bridges Medical Center | Family Medicine | 4380 Cleveland Ave, C3, Fort Myers, FL 33901 | 2011-08-25 |
| 1548587025 | Carl Russell Gillette | Family Medicine | 15448 Fiddlesticks Blvd, Fort Myers, FL 33912-4022 | 2010-04-23 |
| 1982920625 | Locums Doc Inc | Family Medicine | 8772 Tropical Ct, Fort Myers, FL 33908-9240 | 2010-04-19 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.