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General NPI Number Information
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NPI Number | 1982641072
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Entity Type | Organization
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Legal Business Name | CYPRESS SQUARE HEALTH CARE ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 7205 CYPRESS DR
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City | FORT MYERS
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State | FL
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Zip | 33907-2975
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Country | US
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Telephone | 239-278-0136
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Fax | 239-278-3038
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Provider Business Mailing Address
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Address Line | 7205 CYPRESS DR
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City | FORT MYERS
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State | FL
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Zip | 33907-2975
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Country | US
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Telephone | 239-278-0136
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Fax | 239-278-3038
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Authorized Official
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Title or Position | MANAGER
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Name | MS. OLIVIA MICHELLE BATTISTA
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Credential |
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Telephone | 239-278-0136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL7262
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License Number State | FL
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