Provider Demographics
NPI:1497725659
Name:CYPRESS ORTHOPEDICS AND SPORTS MEDICINE P A
Entity Type:Organization
Organization Name:CYPRESS ORTHOPEDICS AND SPORTS MEDICINE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOWDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-243-7411
Mailing Address - Street 1:2113 RUBY RED BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-6105
Mailing Address - Country:US
Mailing Address - Phone:352-243-7411
Mailing Address - Fax:352-394-4257
Practice Address - Street 1:2113 RUBY RED BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-6105
Practice Address - Country:US
Practice Address - Phone:352-243-7411
Practice Address - Fax:352-394-4257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267546300Medicaid
DA3460OtherRAILROAD MEDICARE
FLK2520Medicare ID - Type UnspecifiedMEDICARE
FL267546300Medicaid