Organization · Type 2 NPI

Genesiscare USA of Florida LLC

Surgery Physician · Venice, FL

NPI number 1902580293 Active

Practice location

195 Center Rd Ste B
Venice, FL 34285-5565

Call (941) 492-6227 Map

Fax (941) 492-6335

Mailing address

1419 SE 8th Ter Ste 200
Cape Coral, FL 33990-3213

Specialties and licenses

Taxonomy	Code	License
Surgery Physician Primary	208600000X	None listed
General Practice Physician	208D00000X	None listed

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

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NPI record

NPI: 1902580293
Entity type: Organization (Type 2)
Issued: Jun 15, 2023
Last updated: Nov 3, 2025
Status: Active
Subpart: Yes of Genesiscare Usa, Inc.

Other names

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Genesiscare Gulf Coast Breast Center · doing business as
Genesiscare Gulf Coast Breast Center · doing business as

Authorized official

Ian Wong
CFO
(303) 249-7486

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1902580293

Genesiscare USA of Florida LLC's National Provider Identifier is 1902580293, issued on Jun 15, 2023. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Venice, FL. The record was last updated on Nov 3, 2025.