GENESISCARE OF FLORIDA LLC
NPI 1528442332
Otolaryngology - Plastic Surgery within the Head & Neck in Fort Myers, FL

NPI Status: Active since July 13, 2015

Contact Information

4571 COLONIAL BLVD STE 110
FORT MYERS, FL
ZIP 33966
Phone: (239) 790-3480
Fax: (239) 244-2049

Get Directions Reviews

  • Organization
  • Otolaryngology
  • Plastic Surgery within the Head & Neck
  • Accepts Insurance
  • CLIA Number: 10D0673910
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-02-2027

About GENESISCARE OF FLORIDA LLC

This page provides the complete NPI Profile along with additional information for Genesiscare Of Florida Llc, a provider established in Fort Myers, Florida operating as a Otolaryngology, focusing in plastic surgery within the head & neck . The healthcare provider is registered in the NPI registry with number 1528442332 assigned on July 2015. The practitioner's primary taxonomy code is 207YX0007X. The provider is registered as an organization and their NPI record was last updated January 2025. Genesiscare Of Florida Llc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's . The authorized official of this NPI record is Shaden Marzouk (President)

NPI
1528442332
Provider Legal Name
GENESISCARE OF FLORIDA LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
4571 COLONIAL BLVD STE 110 FORT MYERS, FL 33966
Location Phone
(239) 790-3480
Location Fax
(239) 244-2049
Mailing Address
1419 SE 8TH TER STE 200 CAPE CORAL, FL 33990
Mailing Phone
(239) 931-7342
Mailing Fax
(239) 244-2049
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
07-13-2015
Last Update Date
01-31-2025
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Otolaryngology Plastic Surgery within the Head & Neck

Taxonomy Code
207YX0007X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Y00000XAllopathic & Osteopathic Physicians

Otolaryngology

 

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Clear VALUE Silver - HMO
  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Complete VALUE Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Silver - HMO
  • Elite Silver + Vision + Adult Dental - HMO
  • Elite VALUE Bronze - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Connect Bronze 0 Indiv Med Deductible - EPO
  • Connect Bronze 5500 Indiv Med Deductible - EPO
  • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Bronze CMS Standard - EPO
  • Connect Gold 2000 Indiv Med Deductible - EPO
  • Connect Gold 800 Indiv Med Deductible - EPO
  • Connect Gold CMS Standard - EPO
  • Connect Silver 3600 Indiv Med Deductible - EPO
  • Connect Silver 4300 Indiv Med Deductible - EPO
  • Connect Silver CMS Standard - EPO
  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
  • BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SHADEN MARZOUK

Authorized Official Title
PRESIDENT
Authorized Official Phone
(239) 931-7254

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D0673910
Facility Type
Physician Office
Certificate Effective Date
February 03, 2025
Certificate Expiration Date
February 02, 2027
Laboratory Director
CONSTANTINE A. MANTZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Genesiscare Of Florida Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for GENESISCARE OF FLORIDA LLC

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1528442332
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
254884436
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 4 + 8 + 8 + 4 + 4 + 3 + 6 + 24 = 68
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 68 = 22

The NPI number 1528442332 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1639283534 ALEJANDRO J MIRANDA-SOUSA M.D.
Individual
Urology4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
(239) 226-2727
1528535507 DARIAN YERA APRN
Individual
Nurse Practitioner4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
(239) 226-2727
1255607750 KAILEN GONZALEZ PA
Individual
Physician Assistant (Medical)4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
(786) 218-3593
1043986284GENESISCARE USA OF FLORIDA LLC
Organization
Urology4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
(239) 931-7342
1306655147 NATHALY PACHON
Individual
Physician Assistant (Surgical)4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
(239) 790-3480

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528442332, enumerated in the NPI registry as an "organization" on July 13, 2015

The provider is located at 4571 Colonial Blvd Ste 110 Fort Myers, Fl 33966 and the phone number is (239) 790-3480

This medical organization specializes in Otolaryngology with taxonomy code 207YX0007X with a focus in Plastic Surgery within the Head & Neck

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Superior. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 10D0673910 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on July 13, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.