GENESISCARE OF FLORIDA LLC (NPI# 1528442332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528442332 |
| Entity Type | Organization |
| Organization Name | GENESISCARE OF FLORIDA LLC |
| Other Organization Name | HEAD & NECK SURGICAL CANCER SPECIALISTS OF SW FLORIDA |
| Practice Address |
4571 Colonial Blvd Suite 210 Fort Myers FL 33966-1156 |
| Mailing Address |
2160 Colonial Blvd Fort Myers FL 33907-1410 |
| Practice Telephone | 2393330772 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2020-08-24 |
| Authorized Official Name | DAN COLLINS (PRESIDENT) |
| Authorized Official Telephone | 2399317275 |
| Is Organization Subpart | Y |
| Parent Organization Name | GENESISCARE USA INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Head & Neck Surgical Cancer Specialists of SW Florida | Doing Business As Name - Organization |
| Street Address |
4571 COLONIAL BLVD SUITE 210 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33966-1156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093713489 | Jacob H Goldberger | Surgery | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2005-07-11 |
| 1760963292 | Colonial Outpatient Surgery Center, LLC | Clinic/Center | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2018-08-23 |
| 1275917304 | 21st Century Oncology LLC | Urology | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2015-07-18 |
| 1306274063 | Mark Monzone | Physician Assistant | 4571 Colonial Blvd, Suite 210, Fort Myers, FL 33966-1156 | 2013-10-16 |
| 1588005383 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2013-07-10 |
| 1700140878 | Specialists In Urology, P.a. | Urology | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966-1156 | 2012-07-03 |
| 1912209800 | Specialists In Urology Surgery Center LLC | Clinic/Center | 4571 Colonial Blvd, Suite 200, Fort Myers, FL 33966 | 2010-11-26 |
| 1861707275 | Megan Lavender Menster | Nurse Practitioner | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2010-08-10 |
| 1124258983 | Meagan M Walton | Nurse Practitioner | 4571 Colonial Blvd, Suite 100, Fort Myers, FL 33966-1156 | 2009-07-15 |
| 1801038070 | Scott Von Larson | Otolaryngology | 4571 Colonial Blvd, Fort Myers, FL 33966-1156 | 2009-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962989566 | Samarah A Al-jamali | Dentist | 9330 Ben Pratt/6 Mi Cypress #4, Fort Myers, FL 33966 | 2018-07-26 |
| 1932646171 | Jose M Butron | Behavioral Analyst | 6430 Plantation Park Ct Ste 200, Fort Myers, FL 33966 | 2017-01-26 |
| 1003276833 | Katia Jasmin Robinson Lucero | Social Worker | 3820 Colonial Blvd Suite #102, Fort Myers, FL 33966 | 2016-03-07 |
| 1578947610 | Christian Milanes | Dentist | 9330 Ben C. Pratt Six Mile Cypress Pkwy, Fort Myers, FL 33966 | 2015-07-18 |
| 1003166273 | Reetane Singh | Dentist | 9330 Ben C Pratt Six Mile, Cypress Parkway, Fort Myers, FL 33966 | 2012-09-14 |
| 1518216159 | Lee Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 10140 Deer Run Farms Road, Fort Myers, FL 33966 | 2012-08-29 |
| 1033482724 | Planned Parenthood of Southwest and Central Florida Inc. | Obstetrics & Gynecology | 6418 Commerce Park Drive, Fort Myers, FL 33966 | 2012-02-11 |
| 1013292291 | J Kru Therapy LLC Dba Focus | Physical Therapist | 4997 Royal Gulf Cir, Fort Myers, FL 33966 | 2011-10-19 |
| 1528354651 | American In-home Care, LLC | Home Health | 3800 Colonial Blvd Unit 102, Fort Myers, FL 33966 | 2011-06-27 |
| 1811219256 | Vera Marie Rosado-odom | Internal Medicine | 13340 Metro Pkwy Ste 310, Fort Myers, FL 33966 | 2010-02-26 |
| Find all providers in zip 33966 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699317479 | Ent Associates Pa | Otolaryngology | 3390 Tamiami Trl Ste 201-202, Port Charlotte, FL 33952-8157 | 2019-10-13 |
| 1679878615 | Herbert Kean | Otolaryngology | 799 Crandon Blvd, Apt 1407, Key Biscayne, FL 33149 | 2011-01-24 |
| 1881784841 | Scott Jeffery Trimas | Otolaryngology | 1361 13th Ave South, Ste 125, Jacksonville, FL 32250 | 2006-10-13 |
| 1225032006 | Rangaswamy Asokan | Otolaryngology | 2651 Sw 32nd Pl, Ocala, FL 34471 | 2005-06-09 |
| 1851818686 | Accent Physician Specialists, P.a. | Otolaryngology | 3304 Sw 34th Cir Ste 103, Ocala, FL 34474-3357 | 2017-08-23 |
| 1720527021 | Randall P Weyrich Md LLC | Otolaryngology | 6602 Seabird Way, Apollo Beach, FL 33572-3003 | 2017-02-20 |
| 1326416413 | Edward H. Farrior, Md, Pa | Otolaryngology | 2908 W Azeele St, Tampa, FL 33609-3110 | 2015-09-08 |
| 1225448921 | The Palm Beach Center for Facial Plastic & Laser Surgery, P.a. | Otolaryngology | 4495 Military Trl Ste 202, Jupiter, FL 33458 | 2014-05-02 |
| 1801219944 | Edward J. Gross, M.d., P.l. | Otolaryngology | 1035 Primera Blvd, Lake Mary, FL 32746-2193 | 2014-01-25 |
| 1205175635 | Barnett Facial Plastic & Reconstructive Surgery, Pa. | Otolaryngology | 1032 Mar Walt Dr, Suite 100, Fort Walton Beach, FL 32547-6661 | 2013-02-05 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33966 |
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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.