Contract Details
Ancillary Care Services
Facility name
Cypress Sleep Disorders Center
Provider ID
P000005276
NPI
1760426084
Tax ID
200340145
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
150 Southeast Plaza Roadway
Winter Haven, FL 33880
United States
County
Polk
Phone
8632957799 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address