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General NPI Number Information
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NPI Number | 1386692341
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Entity Type | Organization
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Legal Business Name | DAVID S FORREST OD PA
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11300 NW 87TH CT #115
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4586
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Country | US
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Telephone | 305-332-5332
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Fax |
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Provider Business Mailing Address
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Address Line | 11300 NW 87TH CT #115
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4586
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Country | US
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Telephone | 305-332-5332
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DAVID SHEPARD FORREST
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Credential | O.D.
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Telephone | 305-332-5332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC2857
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License Number State | FL
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