| Cypress At Home | |
|
16451 Healthpark Commons Dr Fort Myers FL 33908-9501 | |
| (239) 489-0023 | |
| (239) 204-2063 |
| Full Name | Cypress At Home |
|---|---|
| Speciality | Internal Medicine |
| Location | 16451 Healthpark Commons Dr, Fort Myers, Florida |
| Authorized Official Name and Position | Troy H Chruchill (ADMINISTRATOR) |
| Authorized Official Contact | 2394890023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cypress At Home 9800 S Healthpark Dr Ste 350 Fort Myers FL 33908-3630 Ph: (239) 489-0023 | Cypress At Home 16451 Healthpark Commons Dr Fort Myers FL 33908-9501 Ph: (239) 489-0023 |
| NPI Number | 1427674373 |
|---|---|
| Provider Enumeration Date | 06/17/2020 |
| Last Update Date | 07/30/2024 |
| Medicare PECOS PAC ID | 1153740915 |
|---|---|
| Medicare Enrollment ID | O20200928001461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427674373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Santokh Walha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164409561 PECOS PAC ID: 1658472642 Enrollment ID: I20100908000172 |
| Provider Name | Bobak Rahmanian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124068325 PECOS PAC ID: 5890715643 Enrollment ID: I20120220000687 |
| Provider Name | Jimmy C Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699092627 PECOS PAC ID: 5799925350 Enrollment ID: I20130703000188 |
| Provider Name | Tyson R Hutchison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063834653 PECOS PAC ID: 7416186523 Enrollment ID: I20140213001124 |
| Provider Name | Louisa L Cannamela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285187955 PECOS PAC ID: 2769766740 Enrollment ID: I20170313001035 |
| Provider Name | Nalinbhai G Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104822584 PECOS PAC ID: 0446209266 Enrollment ID: I20180919003502 |
| Provider Name | Renee Connolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538293568 PECOS PAC ID: 0143313403 Enrollment ID: I20230121000030 |
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