Cypress Lake Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CYPRESS LAKE EYE CARE LLC

Practice address

7171 Cypress Lake Dr
Fort Myers, FL 33907-6521

Phone

(239) 415-3806

NPI assigned

Apr 27, 2019

Last updated

Apr 27, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew John Vaneenenaam, ODNPI 1386909729

Title

Optometrist

Phone

(616) 610-1685

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew John Vaneenenaam, O.D.

  • Optometrist
  • Port Charlotte, FL
  • NPI 1386909729
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556323200000",
    "number": "1669036430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7688 CYPRESS WALK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339665805",
            "telephone_number": "616-610-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 CYPRESS LAKE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339076521",
            "telephone_number": "239-415-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYPRESS LAKE EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-27",
        "last_updated": "2019-04-27",
        "status": "A",
        "authorized_official_last_name": "VANEENENAAM",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "616-610-1685",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivan Cvik, MD
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• Cypress Cove at Healthpark Florida, Inc.
• Cypress Family Medical Center PA
• Cypress Home Medical Inc (Option Care of Southwest Florida)
• Cypress Manor Health Care Associates, LLC (Cypress Community Care Center)
• Cypress Medical Associates of SWFL Inc
• Cypress Pharmacy Inc (Cypress Pharmacy)
• Cypress Pharmacy, Inc (Cypress Wellness LTC)
• Cypress Rehab Center

• Optometrist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.