MEDICARE: DR. DAVID SHEPARD FORREST O.D. PA

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	152W00000X	Optometrist	OPC2857	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	:	1447208780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SHEPARD FORREST O.D. PA

Provider Business Mailing Address
First Line	:	2616 OAKBROOK CT
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33332-3440
Country	:	US
Telephone Number	:	305-332-5332
Fax Number	:

Provider Business Practice Location Address
First Line	:	2616 OAKBROOK CT
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33332-3440
Country	:	US
Telephone Number	:	305-332-5332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/29/2016

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