MEDICARE: CYPRESS COVE CARE CENTER, LLC

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	313M00000X	Nursing Facility/Intermediate Care Facility	SNF1115096	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932100229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYPRESS COVE CARE CENTER, LLC

Provider Business Mailing Address
First Line	:	700 SE DR. MARTIN LUTHER KING AVE
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4855
Country	:	US
Telephone Number	:	352-795-8832
Fax Number	:	352-795-0490

Provider Business Practice Location Address
First Line	:	700 SE DR. MARTIN LUTHER KING JR. AVENUE
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4855
Country	:	US
Telephone Number	:	352-795-8832
Fax Number	:	352-795-0490

Authorized Official
Title or Position	:	CFO
Name	:	SCOTT FISHER
Credential	:
Telephone Number	:	352-417-0360

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/07/2023

Similar Medicare Providers

1275764961 — CYPRESS COVE LESSEE LLC
Practice Location Address:

700 SE 8TH AVE
CRYSTAL RIVER, FL
34429-4855

Practice Phone: 352-795-8832
Practice Fax: 352-795-0490

1679027130 — CHRISTIAN EDUARDO LARA PTA26488
Practice Location Address:

700 SE 8TH AVE
CRYSTAL RIVER, FL
34429-4855

Practice Phone: 352-795-8832
Practice Fax:

1154078483 — COGENT HEALTHCARE OF JACKSONVILLE, LLC
Practice Location Address:

700 SE 8TH AVE
CRYSTAL RIVER, FL
34429-4855

Practice Phone: 239-310-5907
Practice Fax:

1811946866 — YOUNG WON KANG MD
Practice Location Address:

4855 RIVER GREEN PKWY STE 140
DULUTH, GA
30096-8333

Practice Phone: 678-417-0077
Practice Fax: 678-417-0337

1487688438 — THE VEIN DOCTOR, LLC
Practice Location Address:

4855 RIVER GREEN PKWY , SUITE 140
DULUTH, GA
30096-8336

Practice Phone: 678-528-7078
Practice Fax:

1245253236 — DUSKA V DYER MD
Practice Location Address:

4855 RIVER GREEN PKWY , SUITE 700
DULUTH, GA
30096-8336

Practice Phone: 770-622-0880
Practice Fax: 770-622-9875

Directions to “CYPRESS COVE CARE CENTER, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.