Active NPI
Genesiscare USA of Florida LLC
- Hematology & Oncology Physician
- Jacksonville, FL
National Provider Identifier
1710360508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- Legal business name
- GENESISCARE USA OF FLORIDA LLC
- Practice address
- 425 N Lee St Ste 104
Jacksonville, FL 32204-1128 - Phone
- (904) 805-7050
- Fax
- (904) 805-7047
- NPI assigned
- Jun 30, 2015
- Organization subpart
- Yes
- Parent organization
- GENESISCARE USA INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ian Wong
- Title
- Cfo
- Phone
- (303) 249-7486
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Internal Medicine) Physician | 207RH0000X | |||
| Hematology & Oncology Physician | 207RH0003X | Primary |
Addresses
Primary practice location
425 N Lee St Ste 104
Jacksonville, FL 32204-1128
Mailing address
2270 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342
Other names 1
- Regional Consultants in Hematology and Oncology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040204000663 | FL | Part B Supplier - Clinic/Group Practice | 9830082882 |
Receives reassigned benefits from 314 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryLocations
425 N Lee St
Ste 104
Jacksonville, FL 32204
Phone (904) 427-1250
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Jacksonville, FL
- NPI 1023699311
-
- Family Nurse Practitioner
- Jacksonville, FL
- NPI 1326778796
-
- Physician Assistant
- Jacksonville, FL
- NPI 1942993670
-
- Surgery Physician
- Niceville, FL
- NPI 1568400331
-
- Hematology & Oncology Physician
- Jacksonville, FL
- NPI 1023470713
Hematology & Oncology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435622400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762128000000",
"number": "1710360508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2270 COLONIAL BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339071412",
"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": "425 N LEE ST STE 104",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322041128",
"telephone_number": "904-805-7050",
"fax_number": "904-805-7047"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESISCARE USA OF FLORIDA LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GENESISCARE USA INC",
"enumeration_date": "2015-06-30",
"last_updated": "2025-11-03",
"certification_date": "2025-11-03",
"status": "A",
"authorized_official_last_name": "WONG",
"authorized_official_first_name": "IAN",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "303-249-7486"
},
"taxonomies": [
{
"code": "207RH0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Regional Consultants in Hematology and Oncology",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Regional Consultants in Hematology and Oncology",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Jacksonville, FL
- Genesis Rehabilitation Hospital, Inc.
- Genesis Rehabilitation Hospital, Inc.
- Genesis Rehabilitation Hospital, Inc.
- Genesis Support Services
- Genesis Totalhealth and Wellness Center
- Genesys Durable Medical Equipment LLC
- Genmedco LLC
- Genoa Healthcare LLC
- Adrian John Genotti III, CRNA
- Anna Maria Saenz Genotti, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.