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General NPI Number Information
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NPI Number | 1497286454
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Entity Type | Individual
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Provider Name | ANITA FORREST
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Gender | Female
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 3251 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33021
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Country | US
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Telephone | 954-964-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 710 SW 99TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-1010
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Country | US
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Telephone | 954-629-3826
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS955596
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License Number State | FL
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