MEDICARE: DAVID S FORREST OD PA

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	152W00000X	Optometrist	OPC2857	FL

General Provider Information

NPI Number	:	1386692341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID S FORREST OD PA

Provider Business Mailing Address
First Line	:	11300 NW 87TH CT
Second Line	:	#115
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4586
Country	:	US
Telephone Number	:	305-332-5332
Fax Number	:

Provider Business Practice Location Address
First Line	:	11300 NW 87TH CT
Second Line	:	#115
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4586
Country	:	US
Telephone Number	:	305-332-5332
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. DAVID SHEPARD FORREST
Credential	:	O.D.
Telephone Number	:	305-332-5332

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	08/22/2020

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