Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Genesiscare USA of Florida LLC

Organization Urology Physician · NPI 1427339399

Genesiscare USA of Florida LLC is an Urology Physician in Fort Walton Beach, Florida. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

914 Mar Walt Dr Ste B
Fort Walton Beach, FL 32547-6706
Phone: (850) 226-6572
Fax: (850) 862-8564
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X

Record details

NPI number1427339399
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationGenesiscare USA Inc
Authorized official Dan Collins — President · (239) 931-7275
Other names Basil D Fossum Md; Basil D Fossum Md
NPI enumeratedSeptember 6, 2011
Last updated in NPPESAugust 24, 2020
Certification dateAugust 24, 2020
Mailing address2160 Colonial Blvd, Fort Myers, FL 33907-1410

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