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EMERALD COAST UROLOGY
NPI 1174768477
Urology in Fort Walton Beach, FL

Active since December 16, 2008CLIA 10D2346220 · Waiver
909 MAR WALT DR, SUITE 1011, FORT WALTON BEACH, FL 32547(850) 683-3377 Get Directions Write a Review

NPPES record last updated: August 24, 2020. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Aug 24, 2020, Jul 12, 2019 (2 updates tracked since 2019).

About Emerald Coast Urology NPPES

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

EMERALD COAST UROLOGY (NPI 1174768477) is a healthcare organization registered as an urology in Fort Walton Beach, Florida and active in the NPI registry since December 2008. The organization holds a CLIA Waiver certificate valid through June 24, 2028 and lists Dan Collins, President, as its authorized official.

NPPES Registry Identity

NPI1174768477
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGENESISCARE USA OF FLORIDA LLC
Location Address909 MAR WALT DR, SUITE 1011Fort Walton Beach, FL 32547-6635
Mailing Address2160 Colonial BlvdFort Myers, FL 33907-1410 · (239) 931-7342 · Fax (239) 931-7385
Phone(850) 683-3377
Organization SubpartYesParent: Genesiscare Usa Inc
Authorized OfficialDan CollinsPresident · (239) 931-7275
Enumeration DateDecember 16, 2008
Last NPPES UpdateAugust 24, 20202 updates tracked since enumeration
NPPES CertifiedAugust 24, 2020
✔ NPI 1174768477 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.
909 MAR WALT DR, Fort Walton Beach, FL 32547
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Other Names 1

Doing Business AsEmerald Coast Urology

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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

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 10D2346220

Genesiscare Usa Of Florida LLC Dba Sunstate Medical S · Fort Walton Beach, FL
Active · expires Jun 24, 2028
CLIA Number10D2346220
Laboratory TypePhysician Office
Certificate Effective DateJune 25, 2026
Certificate Expiration DateJune 24, 2028
Laboratory DirectorJames Stevens
Laboratory Phone(239) 690-6381
Laboratory LocationGenesiscare Usa Of Florida LLC Dba Sunstate Medical S1026 Mar Walt Drive NW, Fort Walton Beach, FL 32547
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 2

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

ROBERT LAWRENCE LONG M.D.
Urology
909 MAR WALT DR, SUITE 1011
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-3377
EMERALD COAST UROLOGY
Urology
909 MAR WALT DR, SUITE 1011
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-3377

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 1174768477. It was assigned to this organization in the NPPES registry on December 16, 2008. The provider is doing business as Emerald Coast Urology.

Where is Genesiscare Usa Of Florida LLC located?

Genesiscare Usa Of Florida LLC is located at 909 Mar Walt Dr Suite 1011, Fort Walton Beach, FL 32547. The listed phone number is (850) 683-3377.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2346220) is associated with this NPI, valid through June 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 August 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.