Provider Demographics
NPI:1568987527
Name:GENESIS WOMENS HEALTH INC
Entity Type:Organization
Organization Name:GENESIS WOMENS HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CORRIS
Authorized Official - Middle Name:ELMONDA
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-948-4701
Mailing Address - Street 1:16400 NW 2ND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6035
Mailing Address - Country:US
Mailing Address - Phone:305-948-4701
Mailing Address - Fax:
Practice Address - Street 1:16400 NW 2ND AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-6035
Practice Address - Country:US
Practice Address - Phone:305-948-4701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102642207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty