Genesiscare USA of Florida LLC

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

Legal business name

GENESISCARE USA OF FLORIDA LLC

Doing business as

South Florida Surgical Oncology

Practice address

8925 Colonial Center Dr Ste 2000
Fort Myers, FL 33905-7813

Phone

(239) 333-0995

Fax

(844) 615-5267

NPI assigned

Jul 18, 2015

Organization subpart

Yes

Parent organization

GENESISCARE USA INCAs reported in NPPES

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

Authorized official

Name

Shaden Marzouk

Title

President

Phone

(239) 931-7254

Specialties & licenses 1

Addresses

Other names 1

• South Florida Surgical Oncology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence Richard Black, DO

  • Surgery Physician
  • Fort Myers, FL
  • NPI 1114035284
  NPD
• Paul Mark Bloomston, MD

  • Surgical Oncology Physician
  • Fort Myers, FL
  • NPI 1982658225
  NPD
• Peter Edward Hakos, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1942611991
  NPD
• Marija Glodevic Kantarevic, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1609649235
  NPD
• Catalina Mosquera, M.D.

  • Surgical Oncology Physician
  • Fort Myers, FL
  • NPI 1952668667
  NPD

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1659755783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 SE 8TH TER STE 200",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903213",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 COLONIAL CENTER DR STE 2000",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057813",
            "telephone_number": "239-333-0995",
            "fax_number": "844-615-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESISCARE USA OF FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESISCARE USA INC",
        "enumeration_date": "2015-07-18",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "MARZOUK",
        "authorized_official_first_name": "SHADEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-931-7254"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Florida Surgical Oncology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genesiscare USA of Florida LLC
• Genesiscare USA of Florida LLC
• Genesiscare USA of Florida LLC
• Genesiscare USA of Florida LLC
• Genesiscare USA of Florida LLC
• Genesiscare USA of Florida LLC
• Genesiscare USA of Florida LLC
• Genesiscare USA of Florida LLC
• Genoa Healthcare LLC
• Genoa Healthcare LLC

• Surgical Oncology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Surgical Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.