Provider Demographics
NPI:1699013979
Name:CYPRESS HEALTING ARTS CENTER, INC.
Entity Type:Organization
Organization Name:CYPRESS HEALTING ARTS CENTER, INC.
Other - Org Name:CITRUS ALTERNATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE/PRESIDE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:352-746-5669
Mailing Address - Street 1:2639 W NORVELL BRYANT HWY
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-9440
Mailing Address - Country:US
Mailing Address - Phone:352-746-5669
Mailing Address - Fax:352-745-5795
Practice Address - Street 1:2639 W NORVELL BRYANT HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9440
Practice Address - Country:US
Practice Address - Phone:352-746-5669
Practice Address - Fax:352-745-5795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1286171100000X
FLMA 21942225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty