Genesis International Medical Services LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME50820 Issued in FL

Legal business name

GENESIS INTERNATIONAL MEDICAL SERVICES LLC

Practice address

323 W Oak St
Suite a
Kissimmee, FL 34741-4421

Phone

(407) 468-3075

NPI assigned

Apr 3, 2012

Last updated

May 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dale C Newton, M.D.

Title

President/ Medical Director

Phone

(813) 389-7682

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1750647780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7529 TALL TREE CT",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346685849",
            "telephone_number": "407-468-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W OAK ST",
            "address_2": "SUITE A",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414421",
            "telephone_number": "407-468-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS INTERNATIONAL MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-389-7682",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME50820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.