Healthcare Provider Details

I. General information

NPI: 1104096734
Provider Name (Legal Business Name): FORBES & ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16499 NE 19TH AVE SUITE 213
NORTH MIAMI BEACH FL
33162-4105
US

IV. Provider business mailing address

16499 NE 19TH AVE SUITE 213
NORTH MIAMI BEACH FL
33162-4105
US

V. Phone/Fax

Practice location:
  • Phone: 305-576-3266
  • Fax: 305-576-1409
Mailing address:
  • Phone: 305-576-3266
  • Fax: 305-576-1409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. LAURIE JANE FORBES
Title or Position: PRESIDENT
Credential: L.C.S.W.
Phone: 305-576-3266