| Cypress Creek Medical Center,inc | |
|
912 Ne 62nd St Fort Lauderdale FL 33334-4110 | |
| (954) 771-3113 | |
| (954) 771-2856 |
| Full Name | Cypress Creek Medical Center,inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 912 Ne 62nd St, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Avtar Sandhu (PRESIDENT) |
| Authorized Official Contact | 9547713113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cypress Creek Medical Center,inc 912 Ne 62nd St Fort Lauderdale FL 33334-4110 Ph: (954) 771-3113 | Cypress Creek Medical Center,inc 912 Ne 62nd St Fort Lauderdale FL 33334-4110 Ph: (954) 771-3113 |
| NPI Number | 1699048546 |
|---|---|
| Provider Enumeration Date | 02/22/2012 |
| Last Update Date | 02/22/2012 |
| Medicare PECOS PAC ID | 4789833054 |
|---|---|
| Medicare Enrollment ID | O20121001000424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699048546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0041535 (Florida) | Primary |
| Provider Name | Avtar S Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063511863 PECOS PAC ID: 6406005776 Enrollment ID: I20121116000126 |
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