| Genesis Totalhealth And Wellness Center | |
|
10151 Deerwood Park Blvd Ste 250 Jacksonville FL 32256-0566 | |
| (330) 518-3999 | |
| Not Available |
| Full Name | Genesis Totalhealth And Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 10151 Deerwood Park Blvd Ste 250, Jacksonville, Florida |
| Authorized Official Name and Position | Tamara Dukes (CEO) |
| Authorized Official Contact | 3305183999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Totalhealth And Wellness Center 3951 Sherman Hills Pkwy W Jacksonville FL 32210-0436 Ph: (330) 518-3999 | Genesis Totalhealth And Wellness Center 10151 Deerwood Park Blvd Ste 250 Jacksonville FL 32256-0566 Ph: (330) 518-3999 |
| NPI Number | 1104654037 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 10/09/2024 |
| Medicare PECOS PAC ID | 9830624642 |
|---|---|
| Medicare Enrollment ID | O20241203000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104654037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Tamara Lynette Dukes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821606229 PECOS PAC ID: 4486065638 Enrollment ID: I20201119002796 |
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