Genesis

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

OTA9873 Issued in FL

Legal business name

GENESIS

Practice address

15204 W Colonial Dr
Winter Garden, FL 34787-6042

Phone

(407) 877-2394

NPI assigned

May 26, 2012

Organization subpart

No

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

Authorized official

Name

Latricie E Freeman

Title

Cota

Phone

(321) 945-0713

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1337990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337990400000",
    "number": "1548520356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15204 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876042",
            "telephone_number": "407-877-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-26",
        "last_updated": "2012-05-26",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "LATRICIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "321-945-0713"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "OTA9873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sukaina Garilus, RBT
• Dakohta Gaskin, APRN
• Gator Support Services LLC
• Gaya Wellness, PLLC
• Joseph Geffen, D.O., M.P.H.
• Genesis Rehab Services
• Waynetta Gentry
• Jennifer Ann Genua
• Nataliya Gerasimenko, APRN
• Roberto Gil, DMD

• Skilled Nursing Facility in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2012; 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.