Provider Demographics
NPI:1891943726
Name:CYPRESS MEDICAL ASSOCIATES OF SWFL INC
Entity Type:Organization
Organization Name:CYPRESS MEDICAL ASSOCIATES OF SWFL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PVST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DIFRONZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-481-5252
Mailing Address - Street 1:9371 CYPRESS LAKE DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4939
Mailing Address - Country:US
Mailing Address - Phone:239-481-5252
Mailing Address - Fax:
Practice Address - Street 1:9371 CYPRESS LAKE DR
Practice Address - Street 2:SUITE 12
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4939
Practice Address - Country:US
Practice Address - Phone:239-481-5252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57429261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty