Healthcare Provider Details

I. General information

NPI: 1326677501
Provider Name (Legal Business Name): ANDREA LYNN FORRAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W INDIANTOWN RD
JUPITER FL
33458-3533
US

IV. Provider business mailing address

2326 S CONGRESS AVE STE 2D
WEST PALM BEACH FL
33406-7614
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-5577
  • Fax: 561-275-2696
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS20597
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: