Provider Demographics
NPI:1841481116
Name:CYPRESS HEALTH SYSTEMS FLORIDA INC.
Entity type:Organization
Organization Name:CYPRESS HEALTH SYSTEMS FLORIDA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:GILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-528-2801
Mailing Address - Street 1:125 SW 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-2403
Mailing Address - Country:US
Mailing Address - Phone:352-528-2801
Mailing Address - Fax:352-528-3824
Practice Address - Street 1:125 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2403
Practice Address - Country:US
Practice Address - Phone:352-528-2801
Practice Address - Fax:352-528-3824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4424275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10U139OtherMEDICARE SWING BED
FL010114100Medicaid
FL332OtherBCBS OF FL
FL256450500Medicaid
FL72816OtherBC & 'BS
FL332OtherBCBS OF FL
FL10U139OtherMEDICARE SWING BED