Genesis Brain Institute LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

GENESIS BRAIN INSTITUTE LLC

Practice address

3030 N Rocky Point Dr W Ste 665
Tampa, FL 33607-5906

Phone

(727) 784-8600

NPI assigned

Sep 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Renee D Kelly

Title

Administrator

Phone

(727) 784-8600

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1104547322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N ROCKY POINT DR W STE 665",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075906",
            "telephone_number": "727-784-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 N ROCKY POINT DR W STE 665",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075906",
            "telephone_number": "727-784-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS BRAIN INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-784-8600"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gillian Trinette M Generoso, M.D.
• Genes Advice Holdings LLC
• Genes Advice LLC
• Genesis
• Genesis Administration LLC
• Genesis Breast Screening PA
• Genesis Physicians Group LLC
• Megan Rae Geneux
• Tabitha Gennara, APRN
• Douglas G. Genninger, D.D.S.

• Multi-Specialty Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.