Provider Demographics
NPI:1992392500
Name:GENOSUR LLC
Entity Type:Organization
Organization Name:GENOSUR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-434-8523
Mailing Address - Street 1:1951 NW 7TH AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1128
Mailing Address - Country:US
Mailing Address - Phone:844-436-6121
Mailing Address - Fax:281-786-2089
Practice Address - Street 1:1951 NW 7TH AVE STE 600
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1128
Practice Address - Country:US
Practice Address - Phone:844-436-6121
Practice Address - Fax:281-786-2089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory