GENESISCARE USA OF FLORIDA LLC (NPI# 1891036810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891036810 |
| Entity Type | Organization |
| Organization Name | GENESISCARE USA OF FLORIDA LLC |
| Other Organization Name | LAWRENCE R. BLACK, DO |
| Practice Address |
13691 Metro Pkwy Ste 350 Metro Medical Plaza Fort Myers FL 33912-4351 |
| Mailing Address |
2160 Colonial Blvd Fort Myers FL 33907-1410 |
| Practice Telephone | 2397685313 |
| Practice Fax Number | 2397689559 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2020-08-25 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | CE7138 | 01 |
| Other Name | Type Code |
|---|---|
| Lawrence R. Black, DO | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336509546 | Genesiscare Usa of Florida LLC | Surgery | 550 Twin Cities Blvd Ste C, Niceville, FL 32578-1050 | 2016-03-01 |
| 1528423670 | Genesiscare Usa of Florida LLC | Pharmacy | 2234 Colonial Blvd Ste 110, Fort Myers, FL 33907 | 2015-12-16 |
| 1982079380 | Genesiscare Usa of Florida LLC | Surgery | 820 Goodlette-frank Rd N, Naples, FL 34102-5445 | 2015-12-10 |
| 1184095234 | Genesiscare Usa of Florida LLC | Urology | 5065 S State Road 7 Ste 203, Lake Worth, FL 33449-5439 | 2015-10-15 |
| 1770952616 | Genesiscare Usa of Florida LLC | Urology | 3361 South Miami Avenue, Suite 306, Miami, FL 33133-4232 | 2015-09-22 |
| 1659755783 | Genesiscare Usa of Florida LLC | Surgery | 8925 Colonial Center Dr Ste 2000, Fort Myers, FL 33905-7813 | 2015-07-18 |
| 1174915748 | Genesiscare Usa of Florida LLC | Urology | 2721 Del Prado Blvd S Ste 230b, Cape Coral, FL 33904-5993 | 2015-02-19 |
| 1871735480 | Genesiscare Usa of Florida LLC | Urology | 2150 S Andrews Ave Ste 100, Fort Lauderdale, FL 33316-3432 | 2009-03-27 |
| 1972796787 | Genesiscare Usa of Florida LLC | Surgery | 1311 N University Dr, Coral Springs, FL 33071-6622 | 2007-08-24 |
| 1881639482 | Genesiscare Usa of Florida LLC | Colon & Rectal Surgery | 13770 Plantation Rd Ste 2, Fort Myers, FL 33912-4460 | 2006-06-18 |
| Street Address |
13691 METRO PKWY STE 350 METRO MEDICAL PLAZA |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33912-4351 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301263 | Heather Marie Gable | Surgery | 6150 Diamond Centre Ct # 1300, Fort Myers, FL 33912-4367 | 2020-09-21 |
| 1780967430 | Surgical Healing Arts Center, LLC | Surgery | 6150 Diamond Centre Court, Suite 1301, Fort Myers, FL 33912 | 2011-09-20 |
| 1649413907 | Bart Stanley Cuderman | Surgery | 14640 Double Eagle Ct, Fort Myers, FL 33912-1716 | 2009-04-15 |
| 1780835959 | Surgical Consultants of Southwest Florida, LLC | Surgery | 4519 Tilton Ct, Fort Myers, FL 33907-1214 | 2008-10-07 |
| 1912161670 | Brian D Kurland M D P A | Surgery | 13782 Plantation Rd Ste 103, Fort Myers, FL 33912 | 2008-07-11 |
| 1740490002 | Bruce Cleaveland Bacon | Surgery | 6932 Old Whiskey Creek Dr, Fort Myers, FL 33919-1827 | 2007-05-23 |
| 1346468170 | Claude P Lieber | Surgery | 482 Keenan Ct, Fort Myers, FL 33919-3110 | 2007-04-24 |
| 1588782585 | Gilbert Abou Lahoud | Surgery | 6150 Diamond Centre Ct Unit 1200, Fort Myers, FL 33912 | 2007-03-27 |
| 1760580054 | David T Rideout | Surgery | 3050 Champion Ring Rd, Fort Myers, FL 33905-5599 | 2006-09-20 |
| 1265468367 | Thomas L Bass | Surgery | 4519 Tilton Court, Fort Myers, FL 33907 | 2006-06-23 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
Please comment or provide details below to improve the information on GENESISCARE USA OF FLORIDA LLC.
| 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.