Provider Demographics
NPI:1356152177
Name:GENESIS SURGERY CENTER OF FLORIDA, LLC
Entity type:Organization
Organization Name:GENESIS SURGERY CENTER OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEININGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-240-1935
Mailing Address - Street 1:625 6TH AVE S STE 475
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4637
Mailing Address - Country:US
Mailing Address - Phone:727-518-2977
Mailing Address - Fax:727-518-0010
Practice Address - Street 1:625 6TH AVE S STE 475
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4637
Practice Address - Country:US
Practice Address - Phone:727-518-2977
Practice Address - Fax:727-518-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty