MEDICARE: CYPRESS PT MANDEVILLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1235075573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYPRESS PT MANDEVILLE

Provider Business Mailing Address
First Line	:	5404 HIGHWAY 22 STE 200
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-2518
Country	:	US
Telephone Number	:	985-317-0566
Fax Number	:	985-317-0564

Provider Business Practice Location Address
First Line	:	5404 HIGHWAY 22 STE 200
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-2518
Country	:	US
Telephone Number	:	985-317-0566
Fax Number	:	985-317-0564

Authorized Official
Title or Position	:	CREDENTIALING DIRECTOR
Name	:	MRS. REBECCA MCCLUNG SPECHT
Credential	:
Telephone Number	:	985-466-1194

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	05/11/2026

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Directions to “CYPRESS PT MANDEVILLE ” Practice Location

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