Active NPI
Genesiscare USA of Florida LLC
Doing business as Marta A Gonzalez Cancer Center
- Medical Oncology Physician
- Key West, FL
National Provider Identifier
1891196127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- Legal business name
- GENESISCARE USA OF FLORIDA LLC
- Doing business as
- Marta A Gonzalez Cancer Center
- Practice address
- 3426 N Roosevelt Blvd
Key West, FL 33040-4224 - Phone
- (305) 296-0021
- Fax
- (305) 296-0061
- NPI assigned
- Sep 5, 2014
- 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
- Shaden Marzouk
- Title
- President
- Phone
- (239) 931-7254
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Oncology Physician | 207RX0202X | Primary |
Addresses
Primary practice location
3426 N Roosevelt Blvd
Key West, FL 33040-4224
Mailing address
2270 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342
Other names 1
- Marta A Gonzalez Cancer Center
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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Medical Oncology Physician
- New Smyrna Beach, FL
- NPI 1295927739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409875200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687305600000",
"number": "1891196127",
"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": "3426 N ROOSEVELT BLVD",
"city": "KEY WEST",
"state": "FL",
"postal_code": "330404224",
"telephone_number": "305-296-0021",
"fax_number": "305-296-0061"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESISCARE USA OF FLORIDA LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GENESISCARE USA INC",
"enumeration_date": "2014-09-05",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"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": "207RX0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Medical Oncology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Marta A Gonzalez Cancer Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Marta A Gonzalez Cancer Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Key West, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.