Healthcare Provider Details

I. General information

NPI: 1144164542
Provider Name (Legal Business Name): SETH A FOREHAND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5171 ETTA GARRETT RD
BAKER FL
32531-9310
US

IV. Provider business mailing address

5171 ETTA GARRETT RD
BAKER FL
32531-9310
US

V. Phone/Fax

Practice location:
  • Phone: 850-826-0610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberRN9486651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: