MEDICARE: DANIEL LEE FOREHAND REGISTERED NURSE

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	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	RN9429562	FL

General Provider Information

NPI Number	:	1679380414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL LEE FOREHAND REGISTERED NURSE

Provider Business Mailing Address
First Line	:	13321 US HIGHWAY 1
Second Line	:
City	:	JUNO BEACH
State	:	FL
Zip	:	33408-2252
Country	:	US
Telephone Number	:	561-337-3200
Fax Number	:	844-833-5613

Provider Business Practice Location Address
First Line	:	13321 US HIGHWAY 1
Second Line	:
City	:	JUNO BEACH
State	:	FL
Zip	:	33408-2252
Country	:	US
Telephone Number	:	561-337-3200
Fax Number	:	844-833-5613

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

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	12/16/2024

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