NPIMap

Organization Active NPI

Cypress Pharmacy, Inc

Doing business as Cypress Wellness LTC

  • Long Term Care Pharmacy
  • Fort Myers, FL
National Provider Identifier
1740079383
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CYPRESS PHARMACY, INC
Doing business as
Cypress Wellness LTC
Practice address
9451 Cypress Lake Dr
Fort Myers, FL 33919-4909
Phone
(239) 481-7322
Fax
(239) 481-0151
NPI assigned
May 1, 2025
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CYPRESS PHARMACY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Justin Ryan CeravoloNPI 1144586447
Title
Owner
Phone
(239) 481-7322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

9451 Cypress Lake Dr
Fort Myers, FL 33919-4909

Mailing address

9451 Cypress Lake Dr
Fort Myers, FL 33919-4909
Phone (239) 481-7322

Other names 1

  • Cypress Wellness LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cypress Pharmacy3 organizations share this tax ID, including this one
Part of
Cypress Pharmacy

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1740079383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9451 CYPRESS LAKE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194909",
            "telephone_number": "239-481-7322",
            "fax_number": "239-481-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9451 CYPRESS LAKE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194909",
            "telephone_number": "239-481-7322",
            "fax_number": "239-481-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYPRESS PHARMACY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CYPRESS PHARMACY, INC",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "CERAVOLO",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-481-7322"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cypress Wellness LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.