Healthcare Provider Details

I. General information

NPI: 1487233193
Provider Name (Legal Business Name): KATHRYN LYNN FORBES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 06/14/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

V. Phone/Fax

Practice location:
  • Phone: 786-624-2825
  • Fax: 305-669-6531
Mailing address:
  • Phone: 786-624-2825
  • Fax: 305-669-6531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME166700
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: