MEDICARE: ROBERT FORE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP 9285250	FL

General Provider Information

NPI Number	:	1265835375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT FORE FNP-C

Provider Business Mailing Address
First Line	:	8390 CHAMPIONS GATE BLVD
Second Line	:	SUITE 108
City	:	CHAMPIONS GATE
State	:	FL
Zip	:	33896-8310
Country	:	US
Telephone Number	:	407-900-0390
Fax Number	:

Provider Business Practice Location Address
First Line	:	8390 CHAMPIONS GATE BLVD
Second Line	:	SUITE 108
City	:	CHAMPIONS GATE
State	:	FL
Zip	:	33896-8310
Country	:	US
Telephone Number	:	407-900-0390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2014
Last Update Date	:	10/02/2014

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