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GENESISCARE UROLOGY
NPI 1043986284
Urology in Fort Myers, FL

Active since August 18, 2021CLIA Certified · 2 labs
4571 COLONIAL BLVD STE 110, FORT MYERS, FL 33966(239) 931-7342(239) 931-7385 Get Directions Write a Review

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 21, 2023, Aug 18, 2021 (2 updates tracked since 2021).

About Genesiscare Urology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESISCARE UROLOGY (NPI 1043986284) is a healthcare organization registered as an urology in Fort Myers, Florida and active in the NPI registry since August 2021. The organization holds 2 active CLIA laboratory certificates and lists Shaden Marzouk, President, as its authorized official.

NPPES Registry Identity

NPI1043986284
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGENESISCARE USA OF FLORIDA LLC
Location Address4571 COLONIAL BLVD STE 110Fort Myers, FL 33966-1156
Mailing Address1419 Se 8th Ter Ste 200Cape Coral, FL 33990-3213 · (239) 931-7342 · Fax (239) 931-7385
Phone(239) 931-7342
Fax(239) 931-7385
Organization SubpartNo
Authorized OfficialShaden MarzoukPresident · (239) 931-7254
Enumeration DateAugust 18, 2021
Last NPPES UpdateSeptember 25, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2023
✔ NPI 1043986284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
4571 COLONIAL BLVD STE 110, Fort Myers, FL 33966
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Other Names 1

Doing Business AsGenesiscare Urology

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2041903

Genesiscare Usa Of Florida, LLC Dba Sunstate Medical Specialists · Fort Myers, FL
Active · expires May 30, 2028
CLIA Number10D2041903
Laboratory TypePhysician Office
Certificate Effective DateMay 31, 2026
Certificate Expiration DateMay 30, 2028
Laboratory DirectorKelly Elleson
Laboratory Phone(239) 931-7263
Laboratory LocationGenesiscare Usa Of Florida, LLC Dba Sunstate Medical Specialists4571 Colonial Blvd Suite 210, Fort Myers, FL 33966
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D0673910

Genesiscare Usa Of Florida, LLC Dba Sunstate Medical Specialists · Fort Myers, FL
Active · expires Feb 2, 2027
CLIA Number10D0673910
Laboratory TypePhysician Office
Certificate Effective DateFebruary 3, 2025
Certificate Expiration DateFebruary 2, 2027
Laboratory DirectorConstantine A. Mantz
Laboratory Phone(239) 931-7279
Laboratory LocationGenesiscare Usa Of Florida, LLC Dba Sunstate Medical Specialists4571 Colonial Blvd, Suite 100, Fort Myers, FL 33966
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAILEN GONZALEZ PA
Physician Assistant (Medical)
4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
Lee County (786) 218-3593
NATHALY PACHON
Physician Assistant (Surgical)
4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
Lee County (239) 790-3480
GENESISCARE OF FLORIDA LLC
Otolaryngology (Plastic Surgery within the Head & Neck)
4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
Lee County (239) 790-3480
DARIAN YERA APRN
Nurse Practitioner
4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
Lee County (239) 226-2727
ALEJANDRO J MIRANDA-SOUSA M.D.
Urology
4571 COLONIAL BLVD STE 110
FORT MYERS, FL 33966
Lee County (239) 226-2727

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesiscare Usa Of Florida LLC's NPI number?

The NPI number for Genesiscare Usa Of Florida LLC is 1043986284. It was assigned to this organization in the NPPES registry on August 18, 2021. The provider is doing business as Genesiscare Urology.

Where is Genesiscare Usa Of Florida LLC located?

Genesiscare Usa Of Florida LLC is located at 4571 Colonial Blvd Ste 110, Fort Myers, FL 33966. The listed phone number is (239) 931-7342.

What is Genesiscare Usa Of Florida LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Genesiscare Usa Of Florida LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Genesiscare Usa Of Florida LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Genesiscare Usa Of Florida LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Genesiscare Usa Of Florida LLC was last updated on September 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.