Cypress Creek Medical Spa

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0048283 Issued in FL

Legal business name

CYPRESS CREEK MEDICAL SPA

Practice address

1942 Highland Oaks Blvd
Suite a
Lutz, FL 33559-7410

Phone

(813) 948-3838

Fax

(813) 949-0629

NPI assigned

Oct 5, 2011

Organization subpart

Yes

Parent organization

FAMILYCARE OF LAND O LAKES, PAAs reported in NPPES

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

Authorized official

Name

Mrs. Linda Rosequist

Title

Practice Administrator

Phone

(813) 948-3838

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Family Care of Land O Lakes2 organizations share this tax ID, including this one

Part of

Family Care of Land O Lakes

Other organizations with this tax ID 1

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

• Familycare of Wesley Chapel

  • Family Medicine Physician
  • Wesley Chapel, FL
  • NPI 1689873028
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Bruce Rosequist, MD

  • Family Medicine Physician
  • Wesley Chapel, FL
  • NPI 1699771071
  NPD (past)

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1821372129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26827 FOGGY CREEK RD",
            "address_2": "SUITE 101A",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446768",
            "telephone_number": "813-973-7774",
            "fax_number": "813-973-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 HIGHLAND OAKS BLVD",
            "address_2": "SUITE A",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597410",
            "telephone_number": "813-948-3838",
            "fax_number": "813-949-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYPRESS CREEK MEDICAL SPA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILYCARE OF LAND O LAKES, PA",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "ROSEQUIST",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "813-948-3838",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "0048283",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "0040424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "34555",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "CN4592",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francesca Marie Cufino
• Jordan Culpepper
• Preston W Culpepper
• Dominique Culver
• Akilah Cunningham
• Cypress Wellness Center , Inc
• Lindsey Czerniawski
• D Dave Wright Arnp
• Alexander Clayton Dabbs
• Austin Emil Dacanay, DC, MS, CCSP, ICSSD

• Family Medicine Physician in Lutz, FL
• Providers in Lutz, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.